Cost–Utility Analysis of Control-IQ Technology Relative to Conventional Insulin Therapy in Adults with Type 1 Diabetes
Year: 2025
Type: article
Abstract: OBJECTIVE: This study evaluated the cost utility of the t:slim X2 insulin pump with Control-IQ technology (Control-IQ) relative to multiple daily injections (MDIs) and standard insulin pump therapy, both used in combination with continuous glucose monitoring (CGM), in adults with type 1 diabetes from a payer perspective in Belgium. RESEARCH DESIGN AND METHODS: A lifetime cost-utility analysis was conducted using the IQVIA CORE Diabetes Model. Baseline characteristics and treatment effects were informed by the Belgian real-world, multicenter, prospective INRANGE study. Direct medical costs included treatment, complication management, and severe hypoglycemic events. Country-specific costs were based on RIZIV-INAMI data and other publicly available sources. Utility values were based on published literature and included the reduction in fear of hypoglycemia associated with Control-IQ as reported in the INRANGE study. Outcomes included quality-adjusted life years (QALYs) and incremental cost-utility ratios (ICURs). Scenario analyses explored variations in the comparator (MDI + CGM only), reduced HbA1c efficacy, and time horizon. RESULTS: Control-IQ yielded 19.50 QALYs versus 17.92 for MDI and standard insulin pump therapy plus CGM, with total costs of €193,588 and €160,129, respectively, resulting in an ICUR of €21,111/QALY. Scenario analyses confirmed robustness: MDI + CGM as sole comparator (ICUR: €41,701/QALY), reduced HbA1c efficacy (ICUR: €25,967/QALY), and a 20-year time horizon (ICUR: €30,183/QALY). CONCLUSIONS: Control-IQ provides clinical benefits relative to MDI and standard insulin pump therapy plus CGM in adults with type 1 diabetes in Belgium and appears to be cost-effective in this setting, considering commonly used thresholds. These findings support the broader adoption of automated insulin delivery systems in diabetes management.
Authors: Jolien De Meulemeester, Francesca Fiorentino, Nuno Picado, Margaretha M. Visser, Bart Keymeulen, Christophe De Block, Liesbeth Van Huffel, Youri Taes, Dominique Ballaux, Katrien Spincemaille, Joke Marlier, Gerd Vanhaverbeke, Ine Lowyck, Chris Vercammen, Ides M. Colin, Vanessa Preumont, Chantal Mathieu, Jeroen Luyten, Sharon M. Wang, Bimal V. Patel, Jordan E. Pinsker, Pieter Gillard
Institutions: KU Leuven, IQVIA (Portugal), Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, University of Antwerp, Antwerp University Hospital, AZ Sint-Jan, AZ Delta, Ghent University Hospital, AZ Groeninge, Ziekenhuis Oost-Limburg, Imelda Hospital, Cliniques Universitaires Saint-Luc, Tandem Diabetes Care (United States)
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7117561547