Cost-effectiveness of continuous glucose monitoring and intensive insulin therapy for type 1 diabetes

McQueen, R Brett; Ellis, Samuel L; Campbell, Jonathan D; Nair, Kavita V; Sullivan, Patrick W

doi:10.1186/1478-7547-9-13

Cost Effectiveness and Resource Allocation

Table 1 Parameters for Type 1 Diabetes Markov Model

From: Cost-effectiveness of continuous glucose monitoring and intensive insulin therapy for type 1 diabetes

Transition Probabilities [Annual cycle length]^a	Mean	2.5%^b	97.50%	Reference
Retinopathy to blindness	0.101	0.057	0.156	Hoerger et al. [16, 17]
Diabetes with no complications to CHD	0.031	0.018	0.048	Hoerger et al. [16, 17]
Subsequent LEA	0.110	0.062	0.169	Hoerger et al. [16, 17]
Diabetes with no complications to nephropathy	0.072	0.041	0.112	Klein et al. [18]
Nephropathy to CHD	0.022	0.013	0.034	Klein et al. [18]
Nephropathy to ESRD	0.072	0.041	0.109	Hoerger et al. [16, 17]
Diabetes with no complications to neuropathy	0.035	0.020	0.055	Klein et al. [18]
Neuropathy to CHD	0.029	0.016	0.044	Hoerger et al. [16, 17]
Neuropathy to LEA	0.131	0.074	0.200	Hoerger et al. [16, 17]
Neuropathy to nephropathy	0.097	0.055	0.149	Wu et al. [19]
Diabetes with no complications to retinopathy	0.011	0.006	0.017	Hoerger et al. [16, 17]
Retinopathy to CHD	0.028	0.016	0.043	Klein et al. [18]
Cost Parameters [Annual or initial costs represented in 2007 US$] ^c
Blindness and retinopathy	9,912	7,251	12,945	ADA [1]
CGM technology	4,189	3,062	5,492	CGM website [24]
Initial cost of CGM technology	4,809	3,499	6,321	CGM website [24]
CHD	35,271	25,820	46,433	ADA [1]
Diabetes with no complications	6,705	4,879	8,788	ADA [1]
ESRD	36,370	26,377	47,708	ADA [1]
LEA	50,150	36,541	65,798	ADA [1]
Nephropathy	20,161	14,614	26,643	ADA [1]
Neuropathy	25,075	18,226	33,004	ADA [1]
Retinopathy	4,956	3,578	6,489	ADA [1]
Utility Parameters [Annual cycle length] ^a
Blindness	0.569	0.531	0.607	Sullivan et al. [22] ICD-9 250
CHD	0.552	0.513	0.591	Sullivan et al. [22] ICD-9 250, 593
ESRD	0.521	0.485	0.558	Sullivan et al. [22] ICD-9 250, 355
LEA	0.572	0.538	0.604	Sullivan et al. [22] ICD-9 250, 362
Nephropathy	0.575	0.545	0.606	Sullivan et al. [22] ICD-9 250, 355, 593
Nephropathy and CHD	0.516	0.465	0.567	Sullivan et al. [22] ICD-9 250, 593, 410, 413
Neuropathy	0.603	0.573	0.632	Sullivan et al. [22] ICD-9 250, 355, 410, 413
Neuropathy and CHD	0.544	0.495	0.593	Sullivan et al. [22] ICD-9 250, 362, 410, 413
Neuropathy and nephropathy	0.557	0.520	0.595	Sullivan et al. [22] ICD-9 250, 410, 413
Diabetes with no complications	0.757	0.747	0.767	Sullivan et al. [22] ICD-9 250, 593, 586
Retinopathy	0.612	0.581	0.643	Sullivan et al. [22] ICD-9 250, 355, 354
Retinopathy and CHD	0.553	0.503	0.605	Sullivan et al. [22] ICD-9 250, 362, 369
Disutility of age	-0.0003			Sullivan et al. [22]
Other Parameters ^d
CGM risk reduction for CHD	0.050	0.013	0.107	DCCT [20]
CGM risk reduction for nephropathy	0.270	0.006	0.768	DCCT [20]
CGM risk reduction for neuropathy	0.188	0.004	0.593	DCCT [20]
CGM risk reduction for retinopathy	0.306	0.075	0.618	Selvin et al. [21]
Start age	40			Assumption
Years since diagnosis	20			Assumption
Discount rate	0.03			Assumption

a Beta distribution assumed
b Credible range of values from the 2.5th and 97.5th percentiles of the 10,000 second order Monte Carlo simulations
c Gamma distribution assumed for all cost parameters
d Beta distribution assumed for all risk reduction parameters; start age, years since diagnosis, and discount rate were not varied

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ISSN: 1478-7547

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