Table 3.

Results of the sensitivity analyses

Analysis	Discounted direct costs (SEK)			Discounted combined costs (SEK)			Discounted quality-adjusted life expectancy (QALYs)			ICER (SEK per QALY)a
	Smart insulin pen	Standard care	Difference	Smart insulin pen	Standard care	Difference	Smart insulin pen	Standard care	Difference
Base case	635,599	759,869	− 124,270	1,541,648	2,039,643	− 497,995	14.74	13.59	+ 1.15	Smart insulin pens dominant
3-year time horizon	39,204	42,490	− 3286	95,520	141,403	− 45,884	2.21	2.17	+ 0.04	Smart insulin pens dominant
5-year time horizon	68,034	76,006	− 7972	171,264	251,522	− 80,258	3.55	3.47	+ 0.08	Smart insulin pens dominant
10-year time horizon	147,293	172,482	− 25,190	403,989	579,865	− 175,876	6.45	6.26	+ 0.19	Smart insulin pens dominant
Baseline HbA1c of 7.96% (64 mmol/mol)	503,716	590,549	− 86,833	1,232,903	1,630,768	− 397,865	15.80	14.86	+ 0.94	Smart insulin pens dominant
Baseline HbA1c of 7.1% (54 mmol/mol)	425,384	483,414	− 58,030	1,046,641	1,383,286	− 336,645	16.52	15.74	+ 0.78	Smart insulin pens dominant
HbA1c reduction of 0.4% (4 mmol/mol)b	684,446	759,869	− 75,422	1,656,833	2,039,643	− 382,810	14.38	13.59	+ 0.80	Smart insulin pens dominant
HbA1c reduction of 0.8% (9 mmol/mol)b	615,900	759,869	− 143,969	1,489,429	2,039,643	− 550,214	14.91	13.59	+ 1.33	Smart insulin pens dominant
HbA1c treatment effect not applied	758,052	759,869	− 1817	1,840,469	2,039,643	− 199,173	13.83	13.59	+ 0.24	Smart insulin pens dominant
Hypoglycemia difference not applied	649,065	759,869	− 110,803	1,755,774	2,039,643	− 283,869	14.48	13.59	+ 0.90	Smart insulin pens dominant
Treatment switched after 3 yearsc	635,598	663,626	− 28,028	1,541,634	1,648,193	− 106,559	14.74	14.48	+ 0.25	Smart insulin pens dominant
Treatment switched after 5 yearsc	635,598	680,623	− 45,025	1,541,635	1,718,398	− 176,763	14.74	14.33	+ 0.40	Smart insulin pens dominant
Treatment switched after 10 yearsc	635,598	707,083	− 71,485	1,541,635	1,848,503	− 306,868	14.74	14.04	+ 0.70	Smart insulin pens dominant

HbA1c glycated hemoglobin, ICER incremental cost-effectiveness ratio, QALY quality-adjusted life-year, SEK 2018 Swedish krona

^aICER is reported for both direct and combined costs and, in all sensitivity analysis simulations, the outcome of dominance was the same when either direct or combined costs were considered

^bFor the smart insulin pen relative to standard care

^cIn the standard care simulation arm to smart insulin pen use, performed by removing differences in HbA1c, hypoglycemic event rates, and treatment costs from the time of switch until the end of the time horizon