OBJECTIVE Hybrid closed-loop (HCL) therapy is an efficacious management strategy for young people with type 1 diabetes. However, high costs prevent equitable access. We thus sought to evaluate the cost-effectiveness of HCL therapy compared with current care among young people with type 1 diabetes in Australia. RESEARCH DESIGN AND METHODS A patient-level Markov model was constructed to simulate disease progression for young people with type 1 diabetes using HCL therapy versus current care, with follow-up from 12 until 25 years of age. Downstream health and economic consequences were compared via decision analysis. Treatment effects and proportions using different technologies to define “current care” were based primarily on data from an Australian pediatric randomized controlled trial. Transition probabilities and utilities for health states were sourced from published studies. Costs were considered from the Australian health care system’s perspective. An annual discount rate of 5% was applied to future costs and outcomes. Uncertainty was evaluated with probabilistic and deterministic sensitivity analyses. RESULTS Use of HCL therapy resulted in an incremental cost-effectiveness ratio of Australian dollars (AUD) $32,789 per quality-adjusted life year (QALY) gained. The majority of simulations (93.3%) were below the commonly accepted willingness-to-pay threshold of AUD $50,000 per QALY gained in Australia. Sensitivity analyses indicated that the base-case results were robust. CONCLUSIONS In this first cost-effectiveness analysis of HCL technologies for the management of young people with type 1 diabetes, HCL therapy was found to be cost-effective compared with current care in Australia.

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控制成本：青少年混合闭环治疗的成本效益分析

目的 混合闭环 (HCL) 治疗是一种有效的 1 型糖尿病年轻患者管理策略。然而，高成本阻碍了公平获取。因此，我们试图评估 HCL 治疗与澳大利亚 1 型糖尿病年轻人目前的护理相比的成本效益。研究设 通过决策分析比较了下游健康和经济后果。使用不同技术定义“当前护理”的治疗效果和比例主要基于来自澳大利亚儿科随机对照试验的数据。健康状态的转变概率和效用来自已发表的研究。成本是从澳大利亚医疗保健系统的角度考虑的。未来成本和结果采用 5% 的年度贴现率。通过概率和确定性敏感性分析评估不确定性。结果 使用 HCL 治疗后，每获得质量调整生命年 (QALY)，成本效益比增加了 32,789 澳元 (AUD)。大多数模拟 (93.3%) 低于在澳大利亚获得的每个 QALY 50,000 澳元的普遍接受的支付意愿阈值。敏感性分析表明，基本情况的结果是稳健的。结论 在首次对 HCL 技术用于管理 1 型糖尿病年轻人的成本效益分析中，