Part C: costs of adverse events, comorbidities and complications Gamma distributions
Health stateMean Cost (£)SESourceHealth stateMean cost (£)SESource
Adverse events
 Hypoglycaemia18718.69Heller et al 14 DKA with hospitalisation1399140NHS reference costs38
 Ongoing yearly cost of microalbuminuria363.56BNF39 and McEwan et al 40 Ongoing yearly cost of microalbuminuria ongoing363.56BNF39 and McEwan et al 40
 Ongoing yearly cost of ESRD24 4362444NHS reference costs38 Death due to ESRD00Assumed equal to zero
 Clinically confirmed neuropathy27127.14Currie et al 41 Clinical neuropathy27127.14Currie et al 41
 Diabetic foot syndrome2848285NHS Reference costs38 PAD with amputation (year 1)7221722NHS Reference costs38
 Ongoing yearly cost of PAD with amputation43943.93McEwan et al 40
 Background retinopathy14514.47McEwan et al 40 Proliferative retinopathy66166.11McEwan et al 40
 Macular oedema (year 1)5710571.0NICE,42 BNF43 Macular oedema (year 2)3416341.6NICE,42 BNF43
 Macular oedema (year 3)2562256.2NICE,42 BNF43 Macular oedema (ongoing)27727.7NICE,42 BNF43
 Blindness (year 1)1584158Clarke et al 44 Blindness (ongoing)51951.88Clarke et al 44
 First MI (year 1)6788679Clarke et al 44 Second MI (year 1)6788679Clarke et al 44
 Final MI (year 1)6788679Clarke et al 44 Ongoing yearly cost of an MI90490.43Clarke et al 44
 Fatal MI2101210Clarke et al 44 Heart Failure (year 1)3818382Clarke et al 44
 Heart failure (ongoing)1173117Clarke et al 44 Fatal HF3818382Clarke et al 44
 First stroke (year 1)4361436Clarke et al 44 Second stroke4361436Clarke et al 44
 Fatal stroke5684568.45Clarke et al 44 First stroke (ongoing)55955.90Clarke et al 44
 Angina (year 1)3397340Clarke et al 44 Angina (ongoing)95195.09Clarke 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=β01*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.