The cost-effectiveness of continuous subcutaneous insulin infusion compared with XXXX for the management of @entity6 .

@entity1 @entity1723 @entity2794 @entity6
AIMS: To estimate the cost effectiveness of continuous subcutaneous insulin infusion (CSII) compared with @entity2794 ( @entity2794 ) for @entity1 using insulin pumps. METHODS: We constructed a Markov model to estimate the costs and outcomes for @entity1 with @entity1723 ( @entity1723 ) treated with CSII using an insulin pump compared with @entity2794 . Key parameters were obtained from the published scientific literature. The primary outcome was quality-adjusted life years (QALYs). Monte Carlo simulations were undertaken for 10 000 hypothetical @entity1 over 8 years of monthly cycles (the expected life of a pump). RESULTS: Over an 8-year period an average @entity1 could expect to gain 0.48 [standard deviation (sd) 0.20] QALYs using CSII compared with @entity2794 . The additional cost over 8 years for this gain was pounds 5462 (sd pounds 897). The incremental cost per QALY was pounds 11,461 (sd pounds 3656). CSII was most cost-effective in @entity1 who had more than two severe hypoglycaemic events per year and who required admission to hospital at least once every year. Cases where CSII might be not economically viable are cases where @entity6 is well controlled with few severe hypoglycaemic events. Results were most sensitive to the number of hypoglycaemic events per @entity1 and the utility weights used to estimate QALYs. CONCLUSION: CSII is a worthwhile investment when targeted to those who might benefit most.
