Economics of Beta-Cell Replacement Therapy
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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.
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.
KeywordsCost-effectiveness Type 1 diabetes Stem cells Early health technology assessment Islet transplant
C. Bandeiras acknowledges Fundação para a Ciência e a Tecnologia (FCT) for the PhD fellowship PD/BD/105868/2014.
This study received funding from Institute for Bioengineering and Biosciences from Fundação para a Ciencia e Tecnologia (UID/BIO/04565/2013), and Programa Operacional Regional de Lisboa 2020 (Project No. 007317), and through the project PRECISE (PAC-PRECISE-LISBOA-01-0145-FEDER-016394).
Compliance with Ethical Standards
Conflict of Interest
Albert J. Hwa, Joaquim M.S. Cabral, Frederico Castelo Ferreira, and Stan N. Finkelstein declare that they have no conflict of interest.
Catia Bandeiras reports personal fees from Compass Biomedical (fees paid for registration and poster presentation for two conferences in the field of stem cell bioprocessing [Biotech Week Boston 2017 and ISCT 2018]; the presented works are not related to the field of diabetes, as showcased in this manuscript.
Robert A. Gabbay reports being a consultant for Sanofi and on the Advisory boards for Health Reveal, Onduo, Hygeia, and Lark.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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