{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T01:28:57Z","timestamp":1790386137017,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2015,5,28]],"date-time":"2015-05-28T00:00:00Z","timestamp":1432771200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Medtronic SARL"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet. Med."],"published-print":{"date-parts":[[2015,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Continuous subcutaneous insulin infusion (<jats:styled-content style=\"fixed-case\">CSII<\/jats:styled-content>) is increasingly used in clinical practice for the management of selected patients with Type\u00a01 diabetes. Several cost\u2010effectiveness studies comparing <jats:styled-content style=\"fixed-case\">CSII<\/jats:styled-content> vs. multiple insulin injections (<jats:styled-content style=\"fixed-case\">MDI<\/jats:styled-content>) have been reported. The aim was systematically to review these analyses and test the hypothesis that <jats:styled-content style=\"fixed-case\">CSII<\/jats:styled-content> is a cost\u2010effective use of healthcare resources across settings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A literature review was performed using <jats:styled-content style=\"fixed-case\">MEDLINE<\/jats:styled-content>, Cochrane Library and other databases. No time limit or language restrictions were applied. After two rounds of screening, 11 cost\u2010effectiveness analyses were included in the final review, of which nine used the <jats:styled-content style=\"fixed-case\">CORE<\/jats:styled-content> Diabetes Model. A narrative synthesis was conducted and mean cost effectiveness calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">CSII<\/jats:styled-content> was considered cost\u2010effective vs. <jats:styled-content style=\"fixed-case\">MDI<\/jats:styled-content> in Type\u00a01 diabetes in all 11 studies in 8 countries, with a mean (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) incremental cost effectiveness ratio of \u20ac30\u00a0862 (17\u00a0997\u201343\u00a0727), <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content>$40\u00a0143 (23\u00a0409\u201356\u00a0876) per quality\u2010adjusted life year (<jats:styled-content style=\"fixed-case\">QALY<\/jats:styled-content>) gained. <jats:styled-content style=\"fixed-case\">CSII<\/jats:styled-content> was associated with improved life expectancy and quality\u2010adjusted life expectancy (0.4\u20131.1 <jats:styled-content style=\"fixed-case\">QALY<\/jats:styled-content>s in adults), driven by lower HbA<jats:sub>1c<\/jats:sub> and lower frequency of hypoglycaemic events vs. <jats:styled-content style=\"fixed-case\">MDI<\/jats:styled-content>. <jats:styled-content style=\"fixed-case\">CSII<\/jats:styled-content> was associated with higher lifetime direct costs due to higher treatment costs but this was partially offset by cost\u2010savings from reduced diabetes\u2010related complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Published cost\u2010effectiveness analyses show that in Type\u00a01 diabetes <jats:styled-content style=\"fixed-case\">CSII<\/jats:styled-content> is cost\u2010effective vs. <jats:styled-content style=\"fixed-case\">MDI<\/jats:styled-content> across a number of settings for patients who have poor glycaemic control and\/or problematic hypoglycaemia on <jats:styled-content style=\"fixed-case\">MDI<\/jats:styled-content>, with cost\u2010effectiveness highly sensitive to the reduction in HbA<jats:sub>1c<\/jats:sub> and hypoglycaemia frequency associated with <jats:styled-content style=\"fixed-case\">CSII<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.12792","type":"journal-article","created":{"date-parts":[[2015,5,12]],"date-time":"2015-05-12T04:53:21Z","timestamp":1431406401000},"page":"1415-1424","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":67,"title":["Cost\u2010effectiveness of continuous subcutaneous insulin infusion versus multiple daily injections of insulin in Type\u00a01 diabetes: a systematic review"],"prefix":"10.1111","volume":"32","author":[{"given":"S.","family":"Roze","sequence":"first","affiliation":[{"name":"HEVA HEOR Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Smith\u2010Palmer","sequence":"additional","affiliation":[{"name":"Ossian Health Economics and Communications Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.","family":"Valentine","sequence":"additional","affiliation":[{"name":"Ossian Health Economics and Communications Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"de Portu","sequence":"additional","affiliation":[{"name":"Medtronic International S\u00e0rl Tolochenaz Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"N\u00f8rgaard","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Hvidovre University Hospital Hvidovre Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. C.","family":"Pickup","sequence":"additional","affiliation":[{"name":"Diabetes Research Group King's College London School of Medicine Guy's Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,5,28]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.1.6107.204"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMct1113948"},{"key":"e_1_2_7_4_1","unstructured":"National Institute for Health and Clinical Excellence.Continuous subcutaneous insulin infusion for the treatment of diabetes mellitus. NICE technology appraisal guidance 151 2008. Available athttp:\/\/www.nice.org.uk\/nicemedia\/pdf\/ta151guidance.pdfLast accessed 11 October 2013."},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.28.6.1277"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1067\/S0022-3476(03)00579-1"},{"issue":"1","key":"e_1_2_7_7_1","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1089\/dia.2009.0192","article-title":"Insulin pump use in type\u00a02 diabetes","volume":"12","author":"Bode BW","year":"2010","journal-title":"Diabet Technol Therapeut"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.2337\/dcS13-2027"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.324.7339.705"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.26.4.1079"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-008-0974-3"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2008.02486.x"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00592-009-0132-5"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/193229681300700617"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.25.11.2074"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2009.193"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.313.7052.275"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1098-3015(10)66170-0"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.2165\/00019053-200725100-00006"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.3310\/hta8430"},{"key":"e_1_2_7_21_1","first-page":"679","article-title":"[Cost\u2010utility analysis of insulin pumps compared to multiple daily doses of insulin in patients with type 1 diabetes mellitus in Spain]","volume":"80","author":"Conget Donlo I","year":"2006","journal-title":"Rev Esp Salud Publica"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.3310\/hta14110"},{"key":"e_1_2_7_23_1","first-page":"2020","article-title":"[Cost\u2010effectiveness of continuous subcutaneous insulin infusion therapy for type 1 diabetes]","volume":"172","author":"N\u00f8rgaard K","year":"2010","journal-title":"Ugeskr Laeger"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2005.01576.x"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-5491.2003.00991.x"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4733.2008.00478.x"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2009.03.013"},{"key":"e_1_2_7_28_1","unstructured":"LynchP GiardinaS NicolucciA PapoNL OrsiniFederici M MinshallME.Cost\u2010effectiveness analysis of continuous subcutaneous insulin injection vs. multiple daily injections in type\u00a01 diabetes patients: an Italian perspective.Poster presented at the 44th Annual Meeting of the European Association for the Study of Diabetes Rome Italy 7\u201311 September 2008."},{"key":"e_1_2_7_29_1","first-page":"73","article-title":"Cost\u2010effectiveness analysis on continuous subcutaneous insulin infusion and multi\u2010point daily insulin injections in the treatment program of type\u00a02 diabetes","volume":"30","author":"Shu J","year":"2009","journal-title":"Zhonghua Liu Xing Bing Xue Za Zhi"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.2165\/00019053-200826090-00004"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.26.8.2485"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2006.01853.x"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2006.1854_1.x"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.614"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.27.11.2590"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/pdi.732"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2004.1349a.x"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2011.02.001"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.12486"}],"container-title":["Diabetic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fdme.12792","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.12792","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T21:11:58Z","timestamp":1696367518000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dme.12792"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,5,28]]},"references-count":38,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2015,11]]}},"alternative-id":["10.1111\/dme.12792"],"URL":"https:\/\/doi.org\/10.1111\/dme.12792","archive":["Portico"],"relation":{},"ISSN":["0742-3071","1464-5491"],"issn-type":[{"value":"0742-3071","type":"print"},{"value":"1464-5491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,5,28]]},"assertion":[{"value":"2015-05-07","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-05-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}