A modelling study of the budget impact of improved glycaemic control in adults with Type 1 diabetes in the UK.

Aims: To develop a novel interactive budget impact model that assesses affordability of diabetes treatments in specific populations, and to test the model in a hypothetical scenario by estimating cost savings resulting from reduction in HbA1c from ≥69 mmol/mol (8.5%) to a target of 53 mmol/mol (7.0%) in adults with Type 1 diabetes in the UK. Methods: A dynamic, interactive model was created using the projected incidence and progression over a 5‐year horizon of diabetes‐related complications (micro‐ and macrovascular disease, severe hypoglycaemia and diabetic ketoacidosis) for different HbA1c levels, with flexible input of population size, complications and therapy costs, HbA1c distribution and other variables. The model took a National Health Service and societal perspective. Results: The model was developed, and in the proposed hypothetical situation, reductions in complications and expected costs evaluated. Achievement of target HbA1c in individuals with HbA1c ≥69 mmol/mol (8.5%) would reduce expected chronic complications from 6.8 to 1.2 events per 100 person‐years, and diabetic ketoacidosis from 14.5 to 1.0 events per 100 person‐years. Potential cumulative direct cost savings achievable in the modelled population were estimated at £687 m over 5 years (£5,585/person), with total (direct and indirect) savings of £1,034 m (£8,400/person). Conclusions: Implementation of strategies aimed at achieving target glucose levels in people with Type 1 diabetes in the UK has the potential to drive a significant reduction in complication costs. This estimate may provide insights into the potential for investment in achieving savings through improved diabetes care in the UK. What's new?: We describe a new interactive budget impact model that evaluates affordability of diabetes treatments and their independent impact on HbA1c and hypoglycaemia.We tested the model by simulating the effect of reducing HbA1c from ≥69 mmol/mol (8.5%) to 53 mmol/mol (7.0%) in an adult population with Type 1 diabetes in the UK.The model estimated that micro‐ and macro‐complications were reduced by >80%, and total cost savings of more than £8,000/person were achieved over a 5‐year period by strategies that obtain target glycaemic control.The model has potential to provide information about the affordability of diabetes treatments, and thus facilitate better resource planning, budget allocation and treatment uptake. [ABSTRACT FROM AUTHOR]