Table 5.
Summary findings of sensitivity analyses
| Sensitivity analyses | Quality-adjusted life expectancy (QALYs) | Costs in SEK (EUR) | ICER per QALY, SEK (EUR) | ||||
|---|---|---|---|---|---|---|---|
| SAP with automated insulin suspension arm | CSII-alone arm | Δ | SAP with automated insulin suspension arm | CSII-alone arm | Δ | ||
| Increased risk of hypoglycemic events cohort | |||||||
| Base case | 13.110 | 11.233 | 1.877 | 2,671,858 (279,968) | 2,409,462 (252,473) | 262,396 (27,495) | 139,795 (14,648) |
| Direct costs only | 13.110 | 11.233 | 1.877 | 865,183 (90,657) | 491,287 (51,479) | 373,896 (39,178) | 199,199 (20,873) |
| Discount rate (%) | |||||||
| 0 | 21.894 | 18.544 | 3.350 | 6,579,902 (689,468) | 6,128,787 (642,198) | 451,115 (47,270) | 134,673 (14,112) |
| 1.5 | 16.608 | 14.158 | 2.450 | 4,088,838 (428,444) | 3,753,353 (393,291) | 335,485 (35,153) | 136,899 (14,345) |
| Time horizon (years) | |||||||
| 10 | 5.826 | 5.096 | 0.730 | 370,639 (38,837) | 250,385 (26,236) | 120,254 (12,601) | 164,551 (17,242) |
| 20 | 9.458 | 8.208 | 1.250 | 885,744 (92,812) | 697,713 (73,109) | 188,031 (19,703) | 150,437 (15,763) |
| SHE rate (per 100 patient-months) | |||||||
| 1a | 13.110 | 11.349 | 1.761 | 2,671,858 (279,968) | 2,311,857 (242,245) | 360,001 (37,722) | 204,442 (21,422) |
| 4a | 13.110 | 11.087 | 2.023 | 2,671,858 (279,968) | 2,528,567 (264,953) | 143,291 (15,015) | 70,830 (7,422) |
| 8a | 13.110 | 10.853 | 2.257 | 2,671,858 (279,968) | 2,718,837 (284,890) | −46,979 (−4923) | SAP dominant |
| Cohort with uncontrolled HbA1c at baseline | |||||||
| Base case | 9.224 | 8.157 | 1.067 | 1,925,040 (201,713) | 1,656,141 (173,537) | 268,899 (28,176) | 251,896 (26,395) |
| Direct costs only | 9.224 | 8.157 | 1.067 | 742,442 (77,796) | 391,958 (41,071) | 350,484 (36,725) | 328,323 (34,403) |
| Cost SAP | |||||||
| −20% | 9.224 | 8.157 | 1.067 | 1,860,426 (194,943) | 1,656,141 (173,537) | 204,285 (21,406) | 191,368 (20,052) |
| −10% | 9.224 | 8.157 | 1.067 | 1,893,499 (198,408) | 1,656,141 (173,537) | 237,358 (24,871) | 222,349 (23,299) |
| +10% | 9.224 | 8.157 | 1.067 | 1,957,347 (205,098) | 1,656,141 (173,537) | 301,206 (31,562) | 282,160 (29,566) |
| Baseline HbA1c | |||||||
| 7.5% (58 mmol/mol) | 9.379 | 8.632 | 0.747 | 1,869,807 (195,926) | 1,570,484 (164,561) | 299,323 (31,364) | 294,117 (30,819) |
| 8.5% (69 mmol/mol) | 8.994 | 7.911 | 1.083 | 1,993,322 (208,868) | 1,745,989 (182,952) | 247,333 (25,917) | 228,293 (23,921) |
| 9.0% (75 mmol/mol) | 8.797 | 7.680 | 1.117 | 2,057,878 (215,632) | 1,839,073 (192,705) | 218,805 (22,927) | 196,009 (20,539) |
| Complication costs | |||||||
| +20% | 9.224 | 8.157 | 1.067 | 1,979,999 (207,472) | 1,714,693 (179,672) | 265,306 (27,800) | 248,531 (26,042) |
| −20% | 9.224 | 8.157 | 1.067 | 1,870,062 (195,952) | 1,597,567 (167,399) | 272,495 (28,553) | 255,264 (26,748) |
| FoH utility | |||||||
| 0 | 8.418 | 8.157 | 0.261 | 1,925,040 (201,713) | 1,656,141 (173,537) | 268,899 (28,176) | 1,028,295 (107,749) |
| 0.0184 | 8.687 | 8.157 | 0.530 | 1,925,040 (201,713) | 1,656,141 (173,537) | 268,899 (28,176) | 507,261 (53,153) |
| SMBG use | |||||||
| No reductionb | 9.224 | 8.157 | 1.067 | 1,964,416 (205,839) | 1,656,141 (173,537) | 308,275 (32,302) | 288,782 (30,260) |
| 6.11 strips/dayb | 9.224 | 8.157 | 1.067 | 1,950,149 (204,344) | 1,656,141 (173,537) | 294,008 (30,807) | 275,417 (28,859) |
| 2.11 strips/dayb | 9.224 | 8.157 | 1.067 | 1,893,083 (198,365) | 1,656,141 (173,537) | 236,942 (24,828) | 221,960 (23,258) |
| Time horizon (years) | |||||||
| 5 | 3.117 | 2.860 | 0.257 | 278,657 (29,199) | 183,890 (19,269) | 94,767 (9,930) | 368,025 (38,563) |
| 10 | 5.252 | 4.766 | 0.486 | 611,491 (64,074) | 454,224 (47,595) | 157,267 (16,479) | 323,861 (33,935) |
| 20 | 7.729 | 6.929 | 0.800 | 1,254,037 (131,403) | 1,029,125 (107,836) | 224,912 (23,567) | 281,104 (29,455) |
| 40 | 9.102 | 8.062 | 1.040 | 1,855,480 (194,424) | 1,592,990 (166,920) | 262,490 (27,505) | 252,177 (26,424) |
| Discount rate (%) | |||||||
| 0 | 13.517 | 11.796 | 1.721 | 3,408,201 (357,125) | 3,007,405 (315,128) | 400,796 (41,997) | 232,885 (24,403) |
| 1.5 | 11.018 | 9.685 | 1.333 | 2,517,823 (263,827) | 2,194,922 (229,993) | 322,901 (33,835) | 242,237 (25,383) |
| Number of sensors | |||||||
| 43 | 9.157 | 8.157 | 1.000 | 1,908,122 (199,940) | 1,656,141 (173,537) | 251,981 (26,404) | 251,804 (26,385) |
| 61 | 9.343 | 8.157 | 1.186 | 1,967,223 (206,133) | 1,656,141 (173,537) | 311,082 (32,596) | 262,250 (27,480) |
Costs were converted from SEK to EUR using an exchange rate of 1 SEK 1 = 0.10478 EUR (date 1 August 2017)
FoH Fear of hypoglycemia, SHE severe hypoglycemic event, SMBG self-monitoring of blood glucose
aIn CSII arm
bIn SAP arm