{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T15:35:01Z","timestamp":1788449701437,"version":"build-2803163510"},"reference-count":68,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2024,4,30]],"date-time":"2024-04-30T00:00:00Z","timestamp":1714435200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,4,30]],"date-time":"2024-04-30T00:00:00Z","timestamp":1714435200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Technology &amp; Therapeutics"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Despite advances in technology, glycemic outcomes in people with type 1 diabetes (T1D) remain suboptimal. The MiniMed 780G (MM780G) advanced hybrid closed-loop (AHCL) system is the latest technology for T1D management with established safety and efficacy. This study explores the cost-effectiveness of MM780G AHCL compared against multiple daily injections (MDI) plus intermittently scanned continuous glucose monitor (isCGM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A cost-utility analysis was conducted, simulating lifetime outcomes for 1000 T1D individuals, with baseline hemoglobin A1c of 8.4%, using the IQVIA Core Diabetes Model (CDM) v9.5. A Singapore health care payer perspective was taken with 2023 costs applied. Treatment effects were taken from the ADAPT study and treatment-related events from a combination of sources. T1D complication costs were derived from local literature, and health state utilities and disutilities from published literature. Scenario analyses and probabilistic sensitivity analyses (PSAs) explored uncertainty. Cost-effectiveness was assessed based on willingness-to-pay (WTP) thresholds set to Singapore Dollars (SGD) 45,000 (United States Dollars [USD] 33,087) per quality-adjusted life year (QALY) and Singapore's gross domestic product (GDP) per capita of SGD 114,165 (USD 83,941) per QALY.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A switch from MDI plus isCGM to MM780G resulted in expected gains in life-years (+0.78) and QALYs (+1.45). Cost savings through reduction in T1D complications (SGD 25,465; USD 18,723) partially offset the higher treatment costs in the AHCL arm (+SGD 74,538; +USD 54,805), resulting in an estimated incremental cost-effectiveness ratio of SGD 33,797 (USD 24,850) per QALY gained. Findings were robust, with PSA outputs indicating 81% and 99% probabilities of cost-effectiveness at the stated WTP thresholds.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>MM780G is a cost-effective option for people with T1D managed in a Singapore setting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/dia.2023.0455","type":"journal-article","created":{"date-parts":[[2024,1,12]],"date-time":"2024-01-12T13:58:46Z","timestamp":1705067926000},"page":"324-334","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["The Cost-Effectiveness of an Advanced Hybrid Closed-Loop System Compared to Standard Management of Type 1 Diabetes in a Singapore Setting"],"prefix":"10.1177","volume":"26","author":[{"given":"Daphne","family":"Gardner","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Singapore General Hospital, Singapore, Singapore."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mrinmayee","family":"Lakkad","sequence":"additional","affiliation":[{"name":"Medtronic Diabetes, Northridge, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiyu","family":"Qiu","sequence":"additional","affiliation":[{"name":"Medtronic Singapore, Singapore, Singapore."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8884-839X","authenticated-orcid":false,"given":"Yuta","family":"Inoue","sequence":"additional","affiliation":[{"name":"Medtronic Diabetes, Northridge, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5944-4886","authenticated-orcid":false,"given":"Suresh","family":"Rama Chandran","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Singapore General Hospital, Singapore, Singapore."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kael","family":"Wherry","sequence":"additional","affiliation":[{"name":"Medtronic Diabetes, Northridge, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,4,30]]},"reference":[{"key":"e_1_3_6_2_2","unstructured":"International Diabetes Federation (IDF) Diabetes Atlas. 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