Alsaleh AO, Mahieu A, Buompensiere MI, Chrastecka N, Dias RP, Dunne C, Hurtado del Pozo C, Mader J, Piemonti L, Basarir H, Vercauteren J, Overbergh L, Ziegler AG, Mathieu C, Narendran P. Reflections on what might be important in health economic evaluation of type 1 diabetes screening: insights from the EDENT1FI consortium. Poster presented at the 61st Annual Meeting of the European Association for the Study of Diabetes (EASD) 2025; September 18, 2025. Vienna, Austria.

BACKGROUND AND AIMS: A systematic review on economic evaluations of pre-symptomatic Type 1 Diabetes (T1D) screening reveals that cost-effectiveness of existing T1D screening models depend on the extent of decrease in diabetic ketoacidosis (DKA) events and the consequent improvement in long-term glycated haemoglobin (HbA1c) levels. Further research concerning the impact on quality of life (QoL), is essential to understand the value of screening. We seek to address these gaps and assess the impact of these elements on cost-effectiveness.

MATERIALS AND METHODS: The EDENT1FI consortium established a diverse subgroup of stakeholders interested in health economic evaluations who met bi-weekly to refine assumptions, incorporate broader benefits, and enhance data inputs for an improved health economics model for T1D using literature. Based on these inputs, an early cost-effectiveness model for pre-symptomatic T1D screening was developed in Microsoft Excel® and associated key features were identified.

RESULTS: Our model for pre-symptomatic T1D screening has features beyond traditional economic models. Screening can be linked to an immediate short-term HbA1c improvement at stage 3 T1D onset, which subsequently reduces the risk of long-term complications. Pre-symptomatic screening results, whether positive or negative, can significantly influence health-related QoL by impacting the emotional and psychological well-being of both children and their parents, highlighting the importance of addressing these dimensions in early diagnosis. Parents of children diagnosed with T1D events like DKA can face income loss due to the sudden onset and lack of preparation time. Early identification of T1D through screening enables targeted education and monitoring, which can lead to better HbA1c control before stage 3 onset—a "soft landing." The interventions are less effective when applied after onset in unscreened individuals, underscoring the value of early detection and intervention. The model also outlines the organisational impact of different screening strategies, offering insights into how healthcare systems can better manage T1D screening programs. While the model is promising, it requires validation and endorsement by the group to populate evidence and determine the magnitude of effects.

CONCLUSION: This enhanced model offers a comprehensive understanding of the health economic impact of T1D screening. Next steps involve aligning on hypotheses and evidence inclusion. Additional work is required to integrate the value of combining screening for other diseases, like celiac and thyroid, as practiced in some regions within EDENT1FI.