Long-term Cost-Effectiveness of an Automated Insulin Delivery System Versus Multiple Daily Injections of Insulin Plus Continuous Glucose Monitoring in Children and Adults With Type 1 Diabetes in Hong Kong

Aim: The MiniMed 780G (MM780G) automated insulin delivery (AID) system has been shown to improve glycemic control in people with type 1 diabetes (T1D). The aim was to determine the long-term cost-effectiveness of the MM780G versus multiple daily injections of insulin plus continuous glucose monitoring (MDI+CGM) in people with T1D in Hong Kong. Methods: The analysis was performed using the IQVIA Core Diabetes Model. The primary analysis was performed in adults with HbA1c ≥8%, from a payer perspective over a time horizon of 60 years and annual discount rate of 3%. Clinical input data were sourced from a clinical trial, wherein HbA1c reductions from baseline (9.04%) of 1.54% and 0.2% were assumed for MM780G and MDI+CGM, respectively. A secondary analysis was performed for a cohort of children/adolescents starting treatment at <18 years. Results: In the adult base case analysis, the incremental cost-effectiveness ratio (ICER) for MM780G versus MDI+CGM was HKD 348 927 (USD 44 759) per quality-adjusted life year (QALY) gained. In the pediatric analysis, the ICER for MM780G versus MDI+CGM was HKD 300 466 (USD 38 543) per QALY. The use of MM780G was predicted to result in reductions in the incidence of diabetes-related complications in both analyses. Conclusion: Over a long-term time horizon, the use of MM780G was projected to improve clinical outcomes versus MDI+CGM. The MM780G was found to be cost-effective versus MDI+CGM in adults with T1D in Hong Kong who are not achieving glycemic targets; benefits were more pronounced in pediatric users, underscoring the value of initiating AID therapy at a younger age.