Netherlands Study: Are Hybrid Closed-Loop Insulin Pumps Worth the Cost for Type 1 Diabetes?

A study from the Netherlands has found that hybrid closed-loop (HCL) insulin pump systems — sometimes called "artificial pancreas" devices — are likely a cost-effective long-term investment for adults living with Type 1 diabetes (T1D), compared to traditional multiple daily injections (MDI) paired with intermittently scanned glucose monitors.

Researchers at Amsterdam UMC used a well-established diabetes modeling tool to simulate lifetime health and financial outcomes for T1D patients using the MiniMed 670G hybrid closed-loop system versus those relying on insulin injections and flash glucose monitoring. Their findings offer a compelling international data point that US patients and healthcare advocates can use to push for better insurance coverage of advanced diabetes technology.

What the Dutch Researchers Found

The study began with patients whose average HbA1c was 7.8% — a level that, in the US, sits just above the American Diabetes Association's (ADA) general target of below 7.0% for most non-pregnant adults. Using the MiniMed 670G system was projected to reduce HbA1c by 0.4 percentage points, bringing patients meaningfully closer to recommended targets.

Beyond blood sugar control, the HCL system also reduced fear of hypoglycemia (FoH) — a significant quality-of-life burden that many T1D patients know all too well. In glucose terms, the baseline HbA1c of 7.8% corresponds to an estimated average blood sugar of approximately 177 mg/dL (US units), while the post-treatment HbA1c of roughly 7.4% corresponds to about 166 mg/dL.

Over a patient's lifetime, those using the MiniMed 670G gained an average of 2.231 quality-adjusted life years (QALYs) — a measure combining both length and quality of life. The total additional cost came to approximately EUR 13,683 (roughly $14,800 USD), resulting in a cost of just EUR 6,133 per QALY gained (about $6,600 USD).

In healthcare economics, a cost under $50,000–$100,000 per QALY is generally considered cost-effective in the US. By that standard, the Dutch numbers look highly favorable.

Why This Matters for US Patients

In the United States, hybrid closed-loop systems like the MiniMed 670G, Tandem Control-IQ, and Omnipod 5 are FDA-approved but frequently face insurance coverage hurdles. Many T1D patients are denied these devices or forced into lengthy appeals processes.

This Dutch research adds to a growing international body of evidence showing that HCL systems are not just medically superior — they are economically justified. When the lifetime cost of diabetes complications (kidney disease, vision loss, cardiovascular events) is factored in, spending more upfront on better technology saves money in the long run.

The ADA's Standards of Care in Diabetes already recommends CGM and insulin pump therapy for many T1D patients — and real-world international data like this Dutch study help make the economic case that US insurers need to hear.

It's also worth noting that the Netherlands study was sensitive to assumptions about severe hypoglycemia rates — meaning the benefit is even greater for patients who experience dangerous low blood sugar episodes regularly, a common and serious T1D risk.

Talk to Your Care Team

If you have Type 1 diabetes and are currently using multiple daily injections, ask your endocrinologist whether a hybrid closed-loop system might be appropriate for you — and whether international cost-effectiveness data could support an insurance appeal.

Source: Serné, Roze, Buompensiere. "Cost-Effectiveness of Hybrid Closed Loop Insulin Pumps Versus Multiple Daily Injections Plus Intermittently Scanned Glucose Monitoring in People With Type 1 Diabetes in The Netherlands." Advances in Therapy, 2022. PMID: 35226346. DOI: 10.1007/s12325-022-02058-9