Long-term cost-effectiveness analysis: base case results using probabilistic sensitivity analysis
| MDI+DAFNE | Pump+DAFNE | Incremental | |
| Mean lifetime discounted costs per person | |||
| Intervention costs | |||
| Insulin and MDI consumables | £12 215 | £5476 | −£6740 |
| Diabetes-related contacts | £5023 | £6289 | £1266 |
| Insulin pumps and pump consumables | £2228 | £28 967 | £26 739 |
| DAFNE course | £363 | £392 | £29 |
| Subtotal intervention costs | £19 829 | £41 124 | £21 295 |
| Adverse event costs | |||
| Severe hypoglycaemia | £133 | £41 | −£92 |
| Diabetic ketoacidosis | £1161 | £882 | −£279 |
| Subtotal cost of adverse events | £1294 | £922 | −£371 |
| Long-term complication costs | |||
| Nephropathy | £40 786 | £38 853 | −£1933 |
| Neuropathy | £1859 | £1805 | −£53 |
| Retinopathy+macular oedema | £6365 | £6263 | −£102 |
| Myocardial infarction | £1838 | £1844 | £6 |
| Heart failure | £607 | £609 | £2 |
| Stroke | £253 | £254 | £0 |
| Angina | £1134 | £1143 | £8 |
| Total cost of long-term complications | £52 841 | £50 771 | −£2070 |
| Total costs | £73 964 | £92 817 | £18 853 (95% CI £6175 to £31 645) |
| Mean undiscounted life years per person | |||
| Total life years | 28.3181 | 28.7999 | 0.3790 (95% CI −2.7392 to 3.3403) |
| Mean discounted QALYs per person | |||
| QALYs lived (excluding decrements due to complications) | 13.9145 | 14.0292 | 0.1147 |
| QALYs lost due to adverse events | |||
| Severe hypoglycaemia | −0.0014 | −0.0004 | 0.0009 |
| Diabetic ketoacidosis | −0.0075 | −0.0057 | 0.0018 |
| Subtotal QALYs due to adverse events | −0.0088 | −0.0061 | 0.0027 |
| QALYs lost due to complications | |||
| Nephropathy | −0.1853 | −0.1792 | 0.0061 |
| Neuropathy | −0.3092 | −0.3010 | 0.0082 |
| Retinopathy+macular oedema | −0.3316 | −0.3293 | 0.0022 |
| Myocardial infarction | −0.0528 | −0.0532 | −0.0004 |
| Heart failure | −0.0385 | −0.0387 | −0.0002 |
| Stroke | −0.0343 | −0.0345 | −0.0002 |
| Angina | −0.0754 | −0.0761 | −0.0007 |
| Subtotal QALYs lost due to complications | −1.0271 | −1.0120 | 0.0152 |
| Total QALYs | 12.8785 | 13.0111 | 0.1326 (95% CI −0.7087 to 0.9623) |
| Summary | |||
| Total mean discounted costs per person | £80 471 | £99 337 | £18 853 (95% CI £6175 to £31 645) |
| Total mean undiscounted life years per person | 28.3181 | 28.7999 | 0.3790 (95% CI −2.7392 to 3.3403) |
| Total mean discounted QALYs per person | 12.8785 | 13.0111 | 0.1326 (95% CI −0.7087 to 0.9623) |
| ICER (£/QALY gained) | £142 195 | ||
| Probability that pump+DAFNE is cost-effective at a threshold of £20 000 per QALY gained | 14.0% | ||
DAFNE, Dose Adjustment for Normal Eating; ICER, incremental cost-effectiveness ratio; MDI, multiple daily injections; pump, insulin pumps; QALY, quality-adjusted life year.