The Determination of Diabetes Utilities, Costs, and Effects Model: A Cost-Utility Tool Using Patient-Level Microsimulation to Evaluate Sensor-Based Glucose Monitoring Systems in Type 1 and Type 2 Diabetes: Comparative Validation

• Published in: Value in health 2024-04, Vol.27 (4), p.500-507
• Main Authors: Szafranski, Kirk, De Pouvourville, Gerard, Greenberg, Dan, Harris, Stewart, Jendle, Johan, Shaw, Jonathan E., Castro, JeanPierre Coaquira, Poon, Yeesha, Levrat-Guillen, Fleur
• Format: Article
• Language: English
• Subjects: Blood Glucose; Blood Glucose Self-Monitoring; Cost-Benefit Analysis; DEDUCE Model; Diabetes Mellitus, Type 2 - drug therapy; Glucose - therapeutic use; Humans; Patient-Level Microsimulation; Sensor-Based Glucose Monitoring Systems; Tool Use Behavior
• ISSN: 1098-3015; 1524-4733; 1524-4733
• DOI: 10.1016/j.jval.2024.01.010

To assess the accuracy and validity of the Determination of Diabetes Utilities, Costs, and Effects (DEDUCE) model, a Microsoft-Excel-based tool for evaluating diabetes interventions for type 1 and type 2 diabetes. The DEDUCE model is a patient-level microsimulation, with complications predicted based on the Sheffield and Risk Equations for Complications Of type 2 diabetes models for type 1 and type 2 diabetes, respectively. For this tool to be useful, it must be validated to ensure that its complication predictions are accurate. Internal, external, and cross-validation was assessed by populating the DEDUCE model with the baseline characteristics and treatment effects reported in clinical trials used in the Fourth, Fifth, and Ninth Mount Hood Diabetes Challenges. Results from the DEDUCE model were evaluated against clinical results and previously validated models via mean absolute percentage error or percentage error. The DEDUCE model performed favorably, predicting key outcomes, including cardiovascular disease in type 1 diabetes and all-cause mortality in type 2 diabetes. The model performed well against other models. In the Mount Hood 9 Challenge comparison, error was below the mean reported from comparator models for several outcomes, particularly for hazard ratios. The DEDUCE model predicts diabetes-related complications from trials and studies well when compared with previously validated models. The model may serve as a useful tool for evaluating the cost-effectiveness of diabetes technologies. •Existing cost-effectiveness models in diabetes are useful, but they are not suitable for all health technology assessment (HTA) agencies. The Determination of Diabetes Utilities, Costs, and Effects (DEDUCE) model was developed to better meet the needs of those HTA agencies.•To assess the accuracy and validity of the DEDUCE model in type 1 and type 2 diabetes.•DEDUCE predicts diabetes-related complications well when compared with previously validated cost-effectiveness models.•DEDUCE is suitable to assess the cost-effectiveness of diabetes technologies for HTA submissions.