Supplementary materials: Smart connected insulin dose monitoring technologies versus standard of care: a Canadian cost–effectiveness analysis

<b>These are peer-reviewed supplementary tables and figure for the article '</b><b>Smart connected insulin dose monitoring technologies versus standard of care: a Canadian cost–effectiveness analysis</b><b>' published in the</b><b> </b><b><i>Journal of Comparative Effectiveness Research</i></b><b>.</b><b>Progression of risk factors (Table S1)</b><b>Table S1: </b>Physiological Progression table<b>Management settings (Table S2-4)</b><b>Table S2:</b> Proportion of patients on preventive medication<b>Table S3: </b>Screening and patient management proportions<b>Table S4:</b> Sensitivity and specificity of tests<b>Direct Costs (Table S5)</b><b>Table S5: </b>Annual treatment costs applied<b>Table S6: </b>Management and complication costs (CAD)<b>Indirect costs</b><b>Table S7:</b> Indirect cost inputs (CAD)<b>Utility Data</b><b>Table S8:</b> Utilities used in model<b>Scenario analyses</b><b>Table S9:</b> List of scenario analysis<b>Modelling results: Base case (Table S10-11)</b><b>Table S10: </b>Breakdown of costs of the base-case analysis (CAD)<b>Clinical outcomes</b><b>Table S11:</b> Event rate of diabetes-related complications (per 1000 patient-years)<b>Modelling results:</b> <b>Figure S1:</b> Cost-effectiveness acceptability curve. <b>Aim:</b> There is growing interest in novel insulin management systems that improve glycemic control. This study aimed to evaluate the cost–effectiveness of smart connected insulin re-usable pens or caps for disposable insulin pens versus pens without connected capabilities in the management of adult patients with Type 1 diabetes (T1DM) from a Canadian societal perspective. <b>Materials &amp; methods:</b> The IQVIA Core Diabetes Model was utilized to conduct the analyses. Applying data from a non-interventional study, the connected insulin device arm was assumed to result in greater reductions (-0.67%) in glycated hemoglobin from baseline and fewer non-severe hypoglycemic events (-32.87 events/patient annually). Macro- and micro-vascular risks were predicted using the Epidemiology of Diabetes Interventions and Complications study data. Direct and indirect costs and utilities were sourced from literature. Key model outcomes included life years and quality-adjusted life-years (QALYs). Both costs and effects were annually discounted at 1.5% over a 60-year time horizon. Uncertainty was explored in scenario and probabilistic sensitivity analyses (PSA). <b>Results:</b> The connected insulin pen device was associated with lower mean discounted total costs (CAD221,943 vs 266,199; -CAD44,256), improvement in mean life expectancy (25.78 vs 24.29; +1.49 years) and gains in QALYs (18.48 vs 16.74; +1.75 QALYs) over the patient’s lifetime. Most scenario analyses confirmed the base case results. The PSA showed dominance in 99.5% of cases. <b>Conclusion:</b> For adults with T1DM in Canada, a connected insulin pen device is likely to be a cost-effective treatment option associated with greater clinical benefits and lower costs relative to a standard re-usable or disposable pen.<br>