Cost-Effectiveness of Closed-Loop Automated Insulin Delivery Using the Cambridge Hybrid Algorithm in Children and Adolescents With Type 1 Diabetes: Results from a Multicenter 6-Month Randomized Trial Article Swipe
D. Steven Fox
,
Julia Ware
,
Charlotte K. Boughton
,
Janet M. Allen
,
Malgorzata E. Wilinska
,
Martin Tauschmann
,
Louise Denvir
,
Ajay Thankamony
,
Fiona Campbell
,
R. Paul Wadwa
,
Bruce A. Buckingham
,
Nikki Davis
,
Linda A. DiMeglio
,
Nelly Mauras
,
Rachel Besser
,
Atrayee Ghatak
,
Stuart A. Weinzimer
,
Lauren Kanapka
,
Craig Kollman
,
Judy Sibayan
,
Roy W. Beck
,
Korey K. Hood
,
Roman Hovorka
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1177/19322968241231950
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1177/19322968241231950
Background/Objective: The main objective of this study is to evaluate the incremental cost-effectiveness (ICER) of the Cambridge hybrid closed-loop automated insulin delivery (AID) algorithm versus usual care for children and adolescents with type 1 diabetes (T1D). Methods: This multicenter, binational, parallel-controlled trial randomized 133 insulin pump using participants aged 6 to 18 years to either AID (n = 65) or usual care (n = 68) for 6 months. Both within-trial and lifetime cost-effectiveness were analyzed. Analysis focused on the treatment subgroup (n = 21) who received the much more reliable CamAPS FX hardware iteration and their contemporaneous control group (n = 24). Lifetime complications and costs were simulated via an updated Sheffield T1D policy model. Results: Within-trial, both groups had indistinguishable and statistically unchanged health-related quality of life, and statistically similar hypoglycemia, severe hypoglycemia, and diabetic ketoacidosis (DKA) event rates. Total health care utilization was higher in the treatment group. Both the overall treatment group and CamAPS FX subgroup exhibited improved HbA 1C (−0.32%, 95% CI: −0.59 to −0.04; P = .02, and −1.05%, 95% CI: −1.43 to −0.67; P < .001, respectively). Modeling projected increased expected lifespan of 5.36 years and discounted quality-adjusted life years (QALYs) of 1.16 (U.K. tariffs) and 1.52 (U.S. tariffs) in the CamAPS FX subgroup. Estimated ICERs for the subgroup were £19 324/QALY (United Kingdom) and −$3917/QALY (United States). For subgroup patients already using continuous glucose monitors (CGM), ICERs were £10 096/QALY (United Kingdom) and −$33 616/QALY (United States). Probabilistic sensitivity analysis generated mean ICERs of £19 342/QALY (95% CI: £15 903/QALY to £22 929/QALY) (United Kingdom) and −$28 283/QALY (95% CI: −$59 607/QALY to $1858/QALY) (United States). Conclusions: For children and adolescents with T1D on insulin pump therapy, AID using the Cambridge algorithm appears cost-effective below a £20 000/QALY threshold (United Kingdom) and cost saving (United States).
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1177/19322968241231950
- OA Status
- green
- Cited By
- 7
- References
- 34
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4392925887
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W4392925887Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1177/19322968241231950Digital Object Identifier
- Title
-
Cost-Effectiveness of Closed-Loop Automated Insulin Delivery Using the Cambridge Hybrid Algorithm in Children and Adolescents With Type 1 Diabetes: Results from a Multicenter 6-Month Randomized TrialWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2024Year of publication
- Publication date
-
2024-03-17Full publication date if available
- Authors
-
D. Steven Fox, Julia Ware, Charlotte K. Boughton, Janet M. Allen, Malgorzata E. Wilinska, Martin Tauschmann, Louise Denvir, Ajay Thankamony, Fiona Campbell, R. Paul Wadwa, Bruce A. Buckingham, Nikki Davis, Linda A. DiMeglio, Nelly Mauras, Rachel Besser, Atrayee Ghatak, Stuart A. Weinzimer, Lauren Kanapka, Craig Kollman, Judy Sibayan, Roy W. Beck, Korey K. Hood, Roman HovorkaList of authors in order
- Landing page
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https://doi.org/10.1177/19322968241231950Publisher landing page
- Open access
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YesWhether a free full text is available
- OA status
-
greenOpen access status per OpenAlex
- OA URL
-
https://www.ncbi.nlm.nih.gov/pmc/articles/11571777Direct OA link when available
- Concepts
-
Medicine, Type 1 diabetes, Subgroup analysis, Hypoglycemia, Randomized controlled trial, Diabetic ketoacidosis, Pediatrics, Diabetes mellitus, Quality-adjusted life year, Cost effectiveness, Internal medicine, Insulin, Algorithm, Endocrinology, Confidence interval, Mathematics, Risk analysis (engineering)Top concepts (fields/topics) attached by OpenAlex
- Cited by
-
7Total citation count in OpenAlex
- Citations by year (recent)
-
2025: 5, 2024: 2Per-year citation counts (last 5 years)
- References (count)
-
34Number of works referenced by this work
- Related works (count)
-
10Other works algorithmically related by OpenAlex
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| publication_date | 2024-03-17 |
| publication_year | 2024 |
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