{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T00:46:21Z","timestamp":1780706781948,"version":"3.54.1"},"reference-count":42,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T00:00:00Z","timestamp":1750982400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The use of automated insulin delivery (AID) systems is associated with improved glycaemic control in individuals with type 1 diabetes (T1DM). However, AID systems are more expensive than other treatment modalities for T1DM. The aim of this study was to evaluate the long\u2010term cost\u2010effectiveness of AID compared to continuous subcutaneous insulin infusion (CSII) combined with continuous glucose monitoring (CGM) in individuals with T1DM at Kuopio University Hospital, Finland.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>The study included 336 individuals (mean age: 26.7\u2009years, SD: 15.9\u2009years), with a mean duration of diabetes of 16.6\u2009years. Outcomes were projected in the base case of 50\u2009years using the IQVIA CORE Diabetes Model (v10.0). Clinical data were sourced from electronic health records (EHRs), including changes in glycated haemoglobin (HbA1c) and events of hypoglycaemia and ketoacidosis. Costs were expressed in 2023 Euros (EUR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The AID system was associated with an improvement in quality\u2010adjusted life expectancy of 2.3 quality\u2010adjusted life\u2010years (QALYs) compared to CSII plus CGM. These benefits came from the delayed and reduced incidence of diabetes\u2010related complications. The mean HbA1c improvement was 12.1 \u00b1\u200911.7\u2009mmol\/mol (3.3% \u00b1\u20093.2%) in the AID group. Direct costs were estimated to be 26\u2009076 EUR higher for AID than for CSII plus CGM, and AID was associated with an incremental cost\u2010effectiveness ratio (ICER) of 11\u2009184 EUR per QALY gained.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Based on the results of this first cost\u2010effectiveness study conducted in Finland, a willingness\u2010to\u2010pay (WTP) threshold of 50\u2009000 EUR per QALY gained suggests that AID is more cost\u2010effective than CSII plus CGM for the treatment of T1DM in a real\u2010world setting.<\/jats:p>\n                  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