Objective
The objective of this study is threefold. First, it will assess the economic value of alternative strategies to screen children for type 1 diabetes. Second, it will understand physicians’ preferences to recommend preventive treatments for individuals at risk of type 1 diabetes and preferences among parents of children who have or are at risk of type 1 diabetes and adults at risk of type 1 diabetes to seek treatment. Third, it will quantify the budget impact for public health plans to reimburse type 1 diabetes screening and preventive treatment for individuals at risk of type 1 diabetes.
Background Rationale
Development of drugs to prevent or delay type 1 diabetes has sparked global interest in timely identifying individuals at-risk of type 1 diabetes who can benefit from these drugs. Screening and monitoring individuals who are at-risk can also prevent life-threatening diabetes complications. Consequently, several screening programs are underway globally. In Canada, the first population-wide type 1 diabetes screening program, CanScreenT1D, is expected to be launched in Fall 2024.
As preventive treatments for type 1 diabetes enter the market and need for screening grows, several economic questions arise. First, which strategy to screen for type 1 diabetes offers the best value for money? Does screening the entire population for type 1 diabetes outperform screening based on family history in terms of costs and benefits? Second, even if individuals at risk of type 1 diabetes are identified, will physicians recommend these preventive treatments to them and will these individuals seek treatment? If so, which characteristics of these treatments will they value most? Third, given the costs and benefits of screening and uptake of preventive treatments, what will be the budget impacts for payers to reimburse screening and preventive treatment? There is currently little evidence to answer these questions.
Description of Project
The first-ever drug to prevent or delay type 1 diabetes (teplizumab) was approved to be marketed in the US in November 2022. This approval has sparked interest in screening strategies to timely identify individuals at risk of type 1 diabetes who can benefit from this drug. Offering screening and preventive treatment in real-world medical settings will, however, require an understanding of its economic implications for payers and acceptance among patients and physicians. This study will use simulation models to assess the economic value of alternative screening strategies for type 1 diabetes. Next, it will survey parents of children having or at risk of type 1 diabetes, adults at risk of type 1 diabetes and physicians to assess their preferences for preventive treatments. Finally, it will estimate the budget impacts for payers to reimburse screening and preventive treatment for type 1 diabetes.
Anticipated Outcome
This study will provide the first evidence on the economic value of alternative strategies to screen children for type 1 diabetes. Findings from this analysis will help inform decisions on which strategy to adopt in clinical practice. This study will also assess preferences for preventive treatments among parents of children who have or are at risk of type 1 diabetes, at-risk adults and physicians, and shed light on which characteristics of these treatments they consider most important. Lastly, this study will provide the first estimates of the financial impacts for public payers in Canada to reimburse screening and preventive treatment for type 1 diabetes.
Relevance to T1D
Findings from this study will be relevant in informing clinical and reimbursement decisions for screening and preventive treatments for type 1 diabetes globally. They will have particular relevance for Canada as the CanScreenT1D program gets underway and Health Canada considers market approval of drugs to prevent type 1 diabetes.