Part C: costs of adverse events, comorbidities and complications Gamma distributions
Health state	Mean Cost (£)	SE	Source	Health state	Mean cost (£)	SE	Source
Adverse events
Hypoglycaemia	187	18.69	Heller et al 14	DKA with hospitalisation	1399	140	NHS reference costs38
Nephropathy
Ongoing yearly cost of microalbuminuria	36	3.56	BNF39 and McEwan et al 40	Ongoing yearly cost of microalbuminuria ongoing	36	3.56	BNF39 and McEwan et al 40
Ongoing yearly cost of ESRD	24 436	2444	NHS reference costs38	Death due to ESRD	0	0	Assumed equal to zero
Neuropathy
Clinically confirmed neuropathy	271	27.14	Currie et al 41	Clinical neuropathy	271	27.14	Currie et al 41
Diabetic foot syndrome	2848	285	NHS Reference costs38	PAD with amputation (year 1)	7221	722	NHS Reference costs38
Ongoing yearly cost of PAD with amputation	439	43.93	McEwan et al 40
Retinopathy
Background retinopathy	145	14.47	McEwan et al 40	Proliferative retinopathy	661	66.11	McEwan et al 40
Macular oedema (year 1)	5710	571.0	NICE,42 BNF43	Macular oedema (year 2)	3416	341.6	NICE,42 BNF43
Macular oedema (year 3)	2562	256.2	NICE,42 BNF43	Macular oedema (ongoing)	277	27.7	NICE,42 BNF43
Blindness (year 1)	1584	158	Clarke et al 44	Blindness (ongoing)	519	51.88	Clarke et al 44
Cardiovascular
First MI (year 1)	6788	679	Clarke et al 44	Second MI (year 1)	6788	679	Clarke et al 44
Final MI (year 1)	6788	679	Clarke et al 44	Ongoing yearly cost of an MI	904	90.43	Clarke et al 44
Fatal MI	2101	210	Clarke et al 44	Heart Failure (year 1)	3818	382	Clarke et al 44
Heart failure (ongoing)	1173	117	Clarke et al 44	Fatal HF	3818	382	Clarke et al 44
First stroke (year 1)	4361	436	Clarke et al 44	Second stroke	4361	436	Clarke et al 44
Fatal stroke	5684	568.45	Clarke et al 44	First stroke (ongoing)	559	55.90	Clarke et al 44
Angina (year 1)	3397	340	Clarke et al 44	Angina (ongoing)	951	95.09	Clarke et al 44

*The variance covariance matrices used to parameterise the multivariate normal distribution are provided in online supplementary material B tables 4, 7 and 12.
†This variable was included in the original regressions; however, the model would converge when this covariate was included, so this parameters is taken to be a zero value in the total cost formula.
–This value was not included as a covariate in the regression formula and is taken to be a zero value in the total cost formula.
The cost for each total cost in part A is calculated using the following formula:
Total cost=β₀+β₁*individual’s baseline diabetes-related contact cost+β₂*individual’s baseline insulin cost+β₃*individual’s baseline HbA1c (DCCT % scale)+β₄*individual’s treatment at the start of the year (1=pump, 0=MDI)+β₅*(1=switched from pump to MDI, 0=did not switch from pump to MDI)+β₆*(1=Switched from MDI to pump, 0=did not switch from MDI to pump).
BNF, British National Formulary; DAFNE, Dose Adjustment for Normal Eating; DCCT, Diabetes Control and Complications Trial; DKA, diabetic ketoacidosis; DRC, diabetes related contacts; ESRD, end-stage renal disease; HF, heart failure; MDI, multiple daily injections; MI, myocardial infarction; NHS, National Health Service; NICE, National Institute for Health and Care Excellence; PAD, peripheral arterial disease; pump, insulin pumps; REPOSE, Relative Effectiveness of Pumps over Structured Education.