Economics of Beta-Cell Replacement Therapy

Curr Diab Rep. 2019 Aug 2;19(9):75. doi: 10.1007/s11892-019-1203-9.

Abstract

Purpose of review: Type 1 diabetes impacts 1.3 million people in the USA with a total direct lifetime medical cost of $133.7 billion. Management requires a mix of daily exogenous insulin administration and frequent glucose monitoring. Decision-making by the individual can be burdensome.

Recent findings: Beta-cell replacement, which involves devices protecting cells from autoimmunity and allo-rejection, aims at restoring physiological glucose regulation and improving clinical outcomes in patients. Given the significant burden of T1D in the healthcare systems, cost-effectiveness analyses can drive innovation and policymaking in the area. This review presents the health economics analyses performed for donor-derived islet transplantation and the possible outcomes of stem cell-derived beta cells. Long-term cost-effectiveness of islet transplantation depends on the engraftment of these transplants, and the expenses and thresholds assumed by healthcare systems in different countries. Early health technology assessment analyses for stem cell-derived beta-cell replacement suggest manufacturing optimization is necessary to reduce upfront costs.

Keywords: Cost-effectiveness; Early health technology assessment; Islet transplant; Stem cells; Type 1 diabetes.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Blood Glucose / analysis
  • Blood Glucose Self-Monitoring
  • Cost-Benefit Analysis
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / economics
  • Diabetes Mellitus, Type 1 / surgery*
  • Humans
  • Insulin-Secreting Cells / transplantation*
  • Islets of Langerhans Transplantation / economics*
  • Islets of Langerhans Transplantation / methods*

Substances

  • Blood Glucose