Cost-effectiveness of control-IQ automated insulin delivery in adults with type 1 diabetes in Sweden

Type 1 diabetes (T1D) is an increasing clinical and economic concern in Sweden, as well as worldwide. Automated insulin delivery (AID) systems, combining continuous glucose monitoring (CGM) with automated insulin dosing to manage glucose levels, have been evaluated for the impact on glycaemic control and quality of life. This study examines the long-term cost-effectiveness of the AID system Control-IQ compared to standard care-defined as multiple daily injections or insulin pump therapy, both using CGM-in Swedish adults with T1D.

A cost-utility analysis is performed using the IQVIA Core Diabetes Model, integrating clinical data from randomized trials and real-world sources. The model projects diabetes-related complications, direct medical costs and quality-adjusted life years (QALYs) over a lifetime period, applying Swedish-specific cost and discount rates.

Use of Control-IQ results in a gain of 1.080 QALYs and lower projected lifetime rates of severe hypoglycaemia, renal complications, cardiovascular events and ulcer/amputation/neuropathy. Total direct costs are higher, but the incremental cost-utility ratio is 391,705 SEK/QALY, which is below Sweden's commonly accepted threshold of 500,000 SEK/QALY. Sensitivity analyses demonstrate consistent results across different scenarios.

The results indicate that Control-IQ is a cost-effective alternative for Swedish adults with T1D and could be considered for broader use in diabetes care.