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Open Access 03-01-2024 | Type 2 Diabetes | Original Research

Cost-Effectiveness Analysis of a Prescription Digital Therapeutic in Type 2 Diabetes

Authors: Niall J. Davison, Nicole L. Guthrie, Sarah Medland, Paul Lupinacci, Robert J. Nordyke, Mark A. Berman

Published in: Advances in Therapy | Issue 2/2024

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Abstract

Introduction

BT-001 (AspyreRx™) prescription digital therapy, a form of personalized cognitive behavioral therapy, has demonstrated clinically meaningful and durable hemoglobin A1c reductions in patients with type 2 diabetes (T2D). The current study examined the cost-effectiveness of BT-001 plus standard of care (SoC) versus SoC alone in T2D over a lifetime horizon from a healthcare payer perspective.

Methods

We modeled the T2D pathway using an individual patient-level simulation; clinical data were sourced from the intention-to-treat subset of the BT-001 randomized clinical trial (RCT). SoC across both arms included the composition of oral and injectable treatments for T2D. Events were simulated using the United Kingdom Prospective Diabetes Study Outcomes Model 2 risk equation. A 3-month model cycle length was used in the first year, then annual model cycles were used in line with the original risk engine specifications. Patient characteristics informed event equations and Monte Carlo random sampling was used to assess the occurrence of events within each model cycle. Incidence of hypoglycemic events, drug discontinuation, costs, and health utilities and disutility values were sourced from the literature.

Results

From a payer perspective, BT-001 plus SoC versus SoC alone was dominant with a gain in quality-adjusted life years (QALYs) of 0.101 and cost savings of $7343 per patient over the lifetime horizon (i.e., more effective and less costly). BT-001 plus SoC was cost-effective at a willingness-to-pay of $100,000 per QALY (incremental net monetary benefit was $17,443). Savings with BT-001 were primarily driven by a reduction in drug acquisition costs. The reduction in hemoglobin A1c with BT-001 was associated with fewer T2D complications.

Conclusions

BT-001 plus SoC was estimated to dominate SoC alone over the lifetime horizon from a payer perspective, suggesting that using BT-001 can empower patients to better manage their diabetes with the potential for lifelong advantages.
Appendix
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Literature
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Metadata
Title
Cost-Effectiveness Analysis of a Prescription Digital Therapeutic in Type 2 Diabetes
Authors
Niall J. Davison
Nicole L. Guthrie
Sarah Medland
Paul Lupinacci
Robert J. Nordyke
Mark A. Berman
Publication date
03-01-2024
Publisher
Springer Healthcare
Published in
Advances in Therapy / Issue 2/2024
Print ISSN: 0741-238X
Electronic ISSN: 1865-8652
DOI
https://doi.org/10.1007/s12325-023-02752-2

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