Summary: In US adults with type 1 diabetes, a manufacturer-funded cost-effectiveness model populated by a 6-month randomised trial found the MiniMed 780G advanced hybrid closed-loop system cost-effective versus multiple daily injections with intermittently scanned CGM at a willingness-to-pay threshold of $100,000 per QALY, with a base-case incremental cost-effectiveness ratio of $68,402 per QALY over 4 years and $38,842 per QALY over a lifetime horizon.
PICO Summary
| Element | Detail |
|---|---|
| Population | Simulated US adults with type 1 diabetes; treatment effects sourced from a 6-month open-label randomised controlled trial. Long-term outcomes modelled with the IQVIA Core Diabetes Model over 4-year and lifetime horizons. |
| Intervention | MiniMed 780G advanced hybrid closed-loop (AHCL) insulin delivery system. |
| Comparison | Multiple daily injections of insulin with intermittently scanned continuous glucose monitoring (isCGM). |
| Outcome | Cost-effective in the base case at a willingness-to-pay threshold of $100,000 per QALY. Incremental cost-effectiveness ratio $68,402 per QALY over a 4-year horizon and $38,842 per QALY over a lifetime horizon. Cost-effectiveness retained at the $100,000 threshold in 4 of 5 one-way sensitivity analyses. No randomised long-term clinical endpoints; QALYs and complication rates were modelled, not observed. No 95% CIs or p-values reported for the ICERs. |
Expert Commentary
This analysis suggests that the MiniMed 780G system can be considered economically reasonable relative to injection therapy with intermittently scanned monitoring at a $100,000 per QALY threshold, and the lifetime ICER of $38,842 is well within ranges generally regarded as acceptable in US managed-care decision-making. The conclusion should be read with care. This is a decision-analytic model, not a long-term clinical trial; only short-term effects on glycaemia and quality of life were measured directly over 6 months, while complication rates, costs, and quality-adjusted survival across years and a lifetime were simulated. Modelled results are highly sensitive to input assumptions, and one of the five sensitivity analyses already crossed the threshold. The most important caveat is sponsorship: the work was conducted by authors affiliated with the device manufacturer, so device pricing and utility assumptions warrant independent scrutiny before being treated as settled. The underlying trial was also open-label, which can inflate patient-reported quality-of-life gains that feed the utility inputs. Can I use this with my patients? Cautiously, as supportive economic context when discussing AHCL with a motivated adult with type 1 diabetes and a payer who recognises this threshold, but not as proof of clinical superiority. Independent, non-manufacturer cost-effectiveness analyses with longer observed follow-up would strengthen confidence in these favourable ratios.
References
Kommareddi M, Wherry K. Cost-effectiveness of the MiniMed 780G system for type 1 diabetes. Am J Manag Care. 2025;31(4):e79-e86. doi:10.37765/ajmc.2025.89722