Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan;12(1):373-388.
doi: 10.1007/s13300-020-00980-1. Epub 2020 Dec 11.

Smart Insulin Pens are Associated with Improved Clinical Outcomes at Lower Cost Versus Standard-of-Care Treatment of Type 1 Diabetes in Sweden: A Cost-Effectiveness Analysis

Johan Jendle  1 , Åsa Ericsson  2 , Jens Gundgaard  3 , Jonas Bech Møller  3 , William J Valentine  4 , Barnaby Hunt  4
Affiliations

Smart Insulin Pens are Associated with Improved Clinical Outcomes at Lower Cost Versus Standard-of-Care Treatment of Type 1 Diabetes in Sweden: A Cost-Effectiveness Analysis

Johan Jendle et al. Diabetes Ther. 2021 Jan.

Abstract

Introduction: Real-world evidence has demonstrated improved glycemic control and insulin management following introduction of smart insulin pens in a Swedish type 1 diabetes (T1D) population. To understand the implications for healthcare costs and expected health outcomes, this analysis evaluated the long-term cost-effectiveness of introducing smart insulin pens to standard-of-care T1D treatment (standard care) from a Swedish societal perspective.

Methods: Clinical outcomes and healthcare costs (in 2018 Swedish krona, SEK) were projected over patients' lifetimes using the IQVIA CORE Diabetes Model to estimate cost-effectiveness. Clinical data and baseline characteristics for the simulated cohort were informed by population data and a prospective, noninterventional study of a smart insulin pen in a Swedish T1D population. This analysis captured direct and indirect costs, mortality, and the impact of diabetes-related complications on quality of life.

Results: Over patients' lifetimes, smart insulin pen use was associated with per-patient improvements in mean discounted life expectancy (+ 0.90 years) and quality-adjusted life expectancy (+ 1.15 quality-adjusted life-years), in addition to mean cost savings (direct, SEK 124,270; indirect, SEK 373,725), versus standard care. A lower frequency and delayed onset of complications drove projected improvements in quality-adjusted life expectancy and lower costs with smart insulin pens versus standard care. Overall, smart insulin pens were a dominant treatment option relative to standard care across all base-case and sensitivity analyses.

Conclusions: Use of smart insulin pens was projected to improve clinical outcomes at lower costs relative to standard care in a Swedish T1D population and represents a good use of healthcare resources in Sweden.

Keywords: Diabetes complications; Diabetes self-management; Diabetes technology; Digital health; Health technology assessment; Healthcare economics; Hypoglycemia; Insulin therapy; Type 1 diabetes; eHealth.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Projected mean time to onset of complications. Base-case analysis, treatment effects were maintained for patient lifetimes
Fig. 2
Fig. 2
Mean a direct costs and b combined (direct and indirect) costs over patients’ lifetimes. Base-case analysis, treatment effects were maintained for patient lifetimes. SEK, 2018 Swedish krona
See this image and copyright information in PMC

References

    1. DiMeglio LA, Evans-Molina C, Oram RA. Type 1 diabetes. Lancet. 2018;391:2449–2462. doi: 10.1016/S0140-6736(18)31320-5. - DOI - PMC - PubMed
    1. International Diabetes Federation . IDF Diabetes Atlas. 9. Brussels: International Diabetes Federation; 2019. - PubMed
    1. Alva M, Gray A, Mihaylova B, Clarke P. The effect of diabetes complications on health-related quality of life: the importance of longitudinal data to address patient heterogeneity. Health Econ. 2014;23:487–500. doi: 10.1002/hec.2930. - DOI - PubMed
    1. Ahola AJ, Saraheimo M, Forsblom C, Hietala K, Sintonen H, Groop PH. Health-related quality of life in patients with type 1 diabetes-association with diabetic complications (the FinnDiane Study) Nephrol Dial Transplant. 2010;25:1903–1908. doi: 10.1093/ndt/gfp709. - DOI - PubMed
    1. Lind M, Svensson AM, Kosiborod M, et al. Glycemic control and excess mortality in type 1 diabetes. N Engl J Med. 2014;371:1972–1982. doi: 10.1056/NEJMoa1408214. - DOI - PubMed

LinkOut - more resources