Diabetes: Continuous Glucose Monitors Proven Cost-effective, Add To Quality Of Life For Diabetics
A new study based on a 6-month clinical trial, finds that use of a CGM is cost-effective for adult patients with type 1 diabetes when compared to daily use of test strips. The results are well within the thresholds normally used by insurance plans to cover medical devices. Continuous glucose monitors (CGM) offer significant, daily benefits to people with type 1 diabetes, providing near-real time measurements of blood sugar levels, but they can be expensive. A new study by researchers from the University of Chicago Medicine, based on a 6-month clinical trial, finds that use of a CGM is cost-effective for adult patients with type 1 diabetes when compared to daily use of test strips. The results are well within the thresholds normally used by insurance plans to cover medical devices. During the trial, CGMs improved overall blood glucose control for the study group and reduced hypoglycemia, or low blood sugar episodes. The study, published April 12, 2018 in Diabetes Care, a journal from the American Diabetes Association, also simulated the costs and health effects of CGM use over the expected lifetime of patients. It showed that CGMs also increased quality of life by extending the amount of time patients enjoy relatively good health, free of complications. "If you map out the lifetime of a patient, it's impressive. The CGM adds years of life and years of quality life," said Elbert Huang, MD, Associate Director of the Chicago Center for Diabetes Translation Research at the University of Chicago and senior author of the study. "While it does cost additional money, the costs saved by lower risk of complications offsets the upfront costs." A continuous glucose monitor uses a tiny sensor inserted under the skin to test blood sugar levels every few minutes throughout the day and Continue reading >>
How Much Does Continuous Glucose Monitoring Cost?
back to Overview Continuous glucose monitoring (CGM) cost and insurance coverage. Does that phrase make your head spin? These were hot issues in response to our last article where I asked about your experience with CGMs. Like anything we’re considering, the financial impact is a big part of the decision-making process. But because the cost depends so much on your insurance coverage, it can be confusing to find out how much you’ll end up paying. And maybe it’s just me, but I don’t like talking to my health insurance company. It feels complicated and I’m rarely confident in the information I get. Additionally, the information changes depending on when during the benefit year I call. What’s the importance of a benefit year? Typically (in the U.S.), health insurance policies are done on an annual basis, and things like deductibles and out-of-pocket maximums, which act like thresholds, are reset. You’ll usually find your cost to be lower later in the benefit year after they’ve been met (even $0 in some cases). For many, the benefit year is the same as a calendar year, so the end of the year might be a smart time to ask about your coverage again. You might be in for a pleasant surprise for the holidays! More to consider? We also have to keep in mind that each employer’s policy can be different, even with the same insurance company. So even though you and your neighbor both have health insurance from the same company, your individual coverage may be different because you work for different employers. An opportunity? But rather than thinking of all this complexity as a barrier and feeling intimidated by it, I believe it creates an opportunity to leverage companies like Dexcom. They have people whose full-time jobs are to dive into our insurance plans and uncov Continue reading >>
Cost-effectiveness Of G5 Mobile Continuous Glucose Monitoring Device Compared To Self-monitoring Of Blood Glucose Alone For People With Type 1 Diabetes From The Canadian Societal Perspective.
Abstract AIMS: To evaluate the cost-effectiveness of real-time continuous glucose monitoring (CGM) compared to self-monitoring of blood glucose (SMBG) alone in people with type 1 diabetes (T1DM) using multiple daily injections (MDI) from the Canadian societal perspective. METHODS: The IMS CORE Diabetes Model (v.9.0) was used to assess the long-term (50 years) cost-effectiveness of real-time CGM (G5 Mobile CGM System; Dexcom, Inc., San Diego, CA) compared with SMBG alone for a cohort of adults with poorly-controlled T1DM. Treatment effects and baseline characteristics of patients were derived from the DIAMOND randomized controlled clinical trial; all other assumptions and costs were sourced from published research. The accuracy and clinical effectiveness of G5 Mobile CGM is the same as the G4 Platinum CGM used in the DIAMOND randomized clinical trial. Base case assumptions included (a) baseline HbA1c of 8.6%, (b) change in HbA1c of -1.0% for CGM users vs -0.4% for SMBG users, and (c) disutilities of -0.0142 for non-severe hypoglycemic events (NSHEs) and severe hypoglycemic events (SHEs) not requiring medical intervention, and -0.047 for SHEs requiring medical resources. Treatment costs and outcomes were discounted at 1.5% per year. RESULTS: The incremental cost-effectiveness ratio for the base case G5 Mobile CGM vs SMBG was $33,789 CAD/quality-adjusted life-year (QALY). Sensitivity analyses showed that base case results were most sensitive to changes in percentage reduction in hypoglycemic events and disutilities associated with hypoglycemic events. The base case results were minimally impacted by changes in baseline HbA1c level, incorporation of indirect costs, changes in the discount rate, and baseline utility of patients. CONCLUSIONS: The results of this analysis demo Continue reading >>
Continuous Glucose Monitoring
Continuous Glucose Monitoring (CGM) is a means of measuring glucose levels continuously in order to gain insight into patterns and trends in glucose levels throughout the day and night. A Continuous Glucose Monitoring System sensor is worn separately to the pump, inserted under the skin, and measures the level of glucose in the interstitial fluid (fluid in the tissue). The sensor is disposable and changed according to manufacturer recommendations. The cost of CGM including consumables (sensors) is around $5,000 per year. CGM can sound an alarm if the glucose level is changing rapidly. A “hypo” or the trend towards a “hypo” can trigger an alarm alerting the user or family/carer to treat immediately. "Hypo" refers to hypoglycaemia, when the blood glucose level has dropped too low. Alerts can prevent a hypo before it happens and is particularly useful overnight when parents and children are in separate rooms. During the 2016 Federal Election, the Government committed to subsidise continuous glucose monitoring (CGM) technology to assist children and young adults under 21 years of age who face extra challenges managing their type 1 diabetes. Diabetes Australia strongly advocated for CGM funding and has been working constructively with the Federal Government and the Department of Health to ensure the initiative is implemented successfully. The Diabetes Australia funding submission can be read here. The Australian Government is now providing access to subsidised continuous glucose monitoring (CGM) products through the National Diabetes Services Scheme (NDSS). Visit the NDSS website to find out more. There are several continuous glucose monitoring systems available in Australia for people living who require insulin to manage their diabetes. These include: Continue reading >>
Why Perfectly Healthy People Are Using Diabetes Monitors
TIME Health For more, visit TIME Health. For about a month, Tabb Firchau, an entrepreneur living in Seattle, has been wearing a continuous glucose monitor (CGM), a federally approved medical device that tracks blood sugar levels for people with diabetes. The CGM patch has a small needle that probes the inside of his arm, and a sensor that tracks changes to his blood sugar in real-time. The data is then sent to his smartphone. Firchau bought his CGM off eBay for about $300. “I track almost everything, from sleep to exercise,” says Firchau. “I’ve been trying to learn why some days I feel fantastic, and other days I don’t. I had a cinnamon roll recently and my blood glucose doubled in 60 minutes. The monitor helps you understand the costs of the decisions you are making.” He couldn’t get one from his doctor, because Firchau doesn’t actually have diabetes. Rather, he’s part of a small but growing group of people who are wearing CGMs to track—and then hack—what goes on in their own bodies. And if enterprising startups like Sano Intelligence, which Gizmodo wrote about in February, are successful, a CGM marketed to the general public may not that be far off. A healthy person wearing a diabetes device may seem odd, but in the quantified-self movement, people like Firchau say it makes sense to track their blood sugar, especially given all the recent attention to the risks associated with overconsumption of sugar and processed carbohydrates, like diabetes, heart disease, and obesity. Everyone’s blood sugar levels change throughout the day, and especially after they eat, but those fluctuations are important to track for people with diabetes, since their body doesn’t regulate blood sugar on its own. For people without diabetes, however, the pancreas natura Continue reading >>
Reimbursement For Continuous Glucose Monitoring
Go to: Abstract Continuous glucose monitoring (CGM) systems have been available for more than 15 years by now. However, market uptake is relatively low in most countries; in other words, relatively few patients with diabetes use CGM systems regularly. One major reason for the reluctance of patients to use CGM systems is the costs associated (i.e., in most countries no reimbursement is provided by the health insurance companies). In case reimbursement is in place, like in the United States, only certain patient groups get reimbursement that fulfills strict indications. This situation is somewhat surprising in view of the mounting evidence for benefits of CGM usage from clinical trials: most meta-analyses of these trials consistently show a clinically relevant improvement of glucose control associated with a reduction in hypoglycemic events. More recent trials with CGM systems with an improved CGM technology showed even more impressive benefits, especially if CGM systems are used in different combinations with an insulin pump (e.g., with automated bolus calculators and low glucose suspend features). Nevertheless, sufficient evidence is not available for all patient groups, and more data on cost–efficacy are needed. In addition, good data from real-world studies/registers documenting the benefits of CGM usage under daily life conditions would be of help to convince healthcare systems to cover the costs of CGM systems. In view of the ongoing improvements in established needle-type CGM systems, the fact that new CGM technology will come to the market soon (e.g., implantable sensors), that CGM-like systems are quite successfully at least in certain markets (like the flash glucose monitoring systems), and that the first artificial pancreas systems will come to the market in Continue reading >>
Cost-effectiveness Of Continuous Glucose Monitoring For Adults With Type 1 Diabetes Compared With Self-monitoring Of Blood Glucose: The Diamond Randomized Trial.
Diabetes Care. 2018 Jun;41(6):1227-1234. doi: 10.2337/dc17-1821. Epub 2018 Apr 12. OBJECTIVE: This study evaluated the societal cost-effectiveness of continuous glucose monitoring (CGM) in patients with type 1 diabetes (T1D) using multiple insulin injections. RESEARCH DESIGN AND METHODS: In the Multiple Daily Injections and Continuous Glucose Monitoring in Diabetes (DIAMOND) trial, 158 patients with T1D and HbA1c 7.5% were randomized in a 2:1 ratio to CGM or control. Participants were surveyed at baseline and 6 months. Within-trial and lifetime cost-effectiveness analyses were conducted. A modified Sheffield T1D policy model was used to simulate T1D complications. The main outcome was cost per quality-adjusted life-year (QALY) gained. RESULTS: Within the 6-month trial, the CGM group had similar QALYs to the control group (0.462 0.05 vs. 0.455 0.06 years, P = 0.61). The total 6-month costs were $11,032 (CGM) vs. $7,236 (control). The CGM group experienced reductions in HbA1c (0.60 0.74% difference in difference [DiD]), P < 0.01), the daily rate of nonsevere hypoglycemia events (0.07 DiD, P = 0.013), and daily test strip use (0.55 1.5 DiD, P = 0.04) compared with the control group. In the lifetime analysis, CGM was projected to reduce the risk of T1D complications and increase QALYs by 0.54. The incremental cost-effectiveness ratio (ICER) was $98,108 per QALY for the overall population. By extending sensor use from 7 to 10 days in a real-world scenario, the ICER was reduced to $33,459 per QALY. CONCLUSIONS: For adults with T1D using multiple insulin injections and still experiencing suboptimal glycemic control, CGM is cost-effective at the willingness-to-pay threshold of $100,000 per QALY, with improved glucose control and reductions in nonsevere hypoglycemia. 2018 by th Continue reading >>
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Continuous Glucose Monitoring
With Continuous Glucose Monitoring (CGM), you get a more complete picture of your glucose levels, which can lead to better treatment decisions and better glucose control. Without diabetes, your body tracks glucose levels all day and night to ensure the right amount of insulin is released at the right time. To successfully manage diabetes, a monitoring system is needed to consistently check your glucose levels. The most common glucose monitoring solutions are blood glucose meters and continuous glucose monitoring (CGM) systems. Sensor overtape not shown in depiction How Does CGM Work? CGM is a way to measure glucose levels in real-time throughout the day and night. A tiny electrode called a glucose sensor is inserted under the skin to measure glucose levels in tissue fluid. It is connected to a transmitter that sends the information via wireless radio frequency to a monitoring and display device. The device can detect and notify you if your glucose is reaching a high or low limit. The latest Medtronic CGM systems can actually alert you before you reach your glucose limits. CGM systems usually consist of a glucose sensor, a transmitter, and a small external monitor to view your glucose levels. MiniMed insulin pumps have built-in CGM so the information can be conveniently seen on your pump screen. The CGM monitor or insulin pump is small, discreet, and easy-to-wear. It can be attached to your belt, hidden in your pocket, or placed under your clothing. This component will show your current glucose levels and your historical glucose trends. It also notifies you before you reach your low or high glucose limits and if your glucose level rises or falls too quickly. The CGM transmitter is a small, lightweight device that attaches to the glucose sensor, gathers your glucose data, Continue reading >>
3 Reasons Why You’ll Love Wearing A Continuous Glucose Monitor (cgm) For Diabetes
We’ve come a long way in diabetes technology. Just as recent as the 1970s, checking your blood sugar as a type 1 diabetic meant dropping little tablets into your collected urine. “I had to urinate in a cup and then set up a mini science experiment. The system was called Clinitest,” explains Barb Peterson. “You put a pill in the test tube along with 10 drops of urine. If it was blue you were negative or had what was considered no sugar. If it was green it could be anywhere from 100 to 280 mg/dL and it if was orange it was considered high and you could be anywhere from 300 to 1200 mg/dL.” Today, not only do we have glucose meters that give us mostly accurate blood glucose readings within 5 seconds, we also have impressive little gadgets known as CGMs or Continuous Glucose Monitors. A CGM is a two-part device: the first part is a tiny flexible sensor, much smaller than even the thickness of a syringe, that you place in your skin every 1-2 weeks. It sits in your skin comfortably (you don’t feel a thing once it’s in there) with a small adhesive. The second part is the receiver which is smaller than most of today’s cellphones and provides a constant number and graph of your blood sugar (actually, it’s really measuring your glucose with “interstitial fluid,” but let’s not get into that in this article!). Check out these links to learn more about the DexCom CGM or the Medtronic Enlite Sensor CGM. Generally, it’s intended for people with type 1 diabetes, but people with type 2 diabetes who are on insulin may want to consider a CGM as well. As a former insulin pump user I was very skeptical about putting something in my skin and leaving it there for a week or two weeks at a time, because with pumping I often struggled with irritated sites, rashes, and bl Continue reading >>
Is Continuous Glucose Monitoring Worth It?
Continuous glucose monitoring systems (CGMS) may not make life with diabetes any easier. But they can definitely improve health, if you can deal with the hassle and expense. So how do you know if such a system is right for you? As many readers already know, CGMS give a nearly continuous readout of glucose levels in tissue fluid, the wet stuff that oozes out when you have a scrape or a burn. To read these levels, you insert a long-lasting sensor under your skin, a process that feels similar to a needle stick. The sensor is made of material like the filters used in dialysis. It measures glucose levels and radios the results, via a connected transmitting device, to a small receiving device about the size of a pager. This sounds nice — much more information without all the needle sticks. Unfortunately, you still have to do fingertip blood checks 2–4 times a day to keep the monitor calibrated. And the information you get from the meter is only valuable if you know how to use it. Originally, CGMS was for your doctor. You got a continuous 72-hour readout of blood sugar levels, with a nice graph to go with it. If you conscientiously wrote down what you ate, your exercise, and medicines, your doctor would learn a lot about your body’s use of food and insulin. The doc could adjust insulin dosages and other aspects of your care. Then you gave the monitor back. Studies showed this treatment reduced A1C levels by 0.4% to 1.0% or so. Many people with diabetes wanted this capability for themselves, so they could regularly adjust their own treatment and self-management. Now thousands of people use CGMS continuously. But how well do they work? Advantages According to manufacturers’ data, “You can easily and discreetlyview your current glucose values continuously throughout the Continue reading >>
The Cost-effectiveness Of Continuous Glucose Monitoring In Type 1 Diabetes
Go to: Abstract Continuous glucose monitoring (CGM) has been found to improve glucose control in type 1 diabetic patients. We estimated the cost-effectiveness of CGM versus standard glucose monitoring in type 1 diabetes. This societal cost-effectiveness analysis (CEA) was conducted in trial populations in which CGM has produced a significant glycemic benefit (A1C ≥7.0% in a cohort of adults aged ≥25 years and A1C <7.0% in a cohort of all ages). Trial data were integrated into a simulation model of type 1 diabetes complications. The main outcome was the cost per quality-adjusted life-year (QALY) gained. RESULTS During the trials, CGM patients experienced an immediate quality-of-life benefit (A1C ≥7.0% cohort: 0.70 quality-adjusted life-weeks [QALWs], P = 0.49; A1C <7.0% cohort: 1.39 QALWs, P = 0.04) and improved glucose control. In the long-term, CEA for the A1C ≥7.0% cohort, CGM was projected to reduce the lifetime probability of microvascular complications; the average gain in QALYs was 0.60. The incremental cost-effectiveness ratio (ICER) was $98,679/QALY (95% CI −60,000 [fourth quadrant] to −87,000 [second quadrant]). For the A1C <7.0% cohort, the average gain in QALYs was 1.11. The ICER was $78,943/QALY (15,000 [first quadrant] to −291,000 [second quadrant]). If the benefit of CGM had been limited to the long-term effects of improved glucose control, the ICER would exceed $700,000/QALY. If test strip use had been two per day with CGM long term the ICER for CGM would improve significantly. Long-term projections indicate that CGM is cost-effective among type 1 diabetic patients at the $100,000/QALY threshold, although considerable uncertainty surrounds these estimates. Continue reading >>
Study Suggests Cost-effectiveness Of Cgm Will Rise As Technology Improves
Study Suggests Cost-Effectiveness of CGM Will Rise as Technology Improves In Focus Blog Published on: April 16, 2018 Study Suggests Cost-Effectiveness of CGM Will Rise as Technology Improves Researchers found that cost-effectiveness calculations shifted dramatically when they assumed people with diabetes used continuous glucose monitoring (CGM) sensors for 10 days instead of 7 days. This is significant because Dexcom just received approval for a next-generation CGM system with a factory-calibrated 10-day sensor. On their own, results published last week in Diabetes Care were welcome news among advocates for covering continuous glucose monitoring (CGM) systems: A study from the University of Chicago found that CGM use falls within accepted cost-effectiveness thresholds used by health plans to cover medical devices. Whats more, the researchers found that cost-effectiveness increased when their models mimicked what happens in the real world. A CGM system uses a device called a sensor inserted under the skin to test blood sugar every few minutes and feed the results to a receiver or, increasingly, to patients smartphones. The FDA approval for the device tested in the Diabetes Care study calls for the sensor to be replaced every 7 days. But the researchers noted that in practice, patients seeking to save money wear sensors up to 10 days. This makes a difference in the cost-effectiveness calculations. And as sensors continue to last longergiven whats in the pipelinethe cost-effectiveness argument will tilt even more heavily in favor of CGM, allowing the technology to penetrate beyond those with type 1 diabetes (T1D) to the 29 million Americans who have type 2 diabetes (T2D). New results from the DIAMOND study evaluated 158 patients with T1D who started the study with glycate Continue reading >>
Cgm Lends Long-term Cost Savings In Type 1 Diabetes
CGM lends long-term cost savings in type 1 diabetes Please provide your email address to receive an email when new articles are posted on this topic. Receive an email when new articles are posted on this topic. For adults with type 1 diabetes using multiple insulin injections, continuous glucose monitoring is a cost-effective alternative to self-monitoring blood glucose, according to findings published in Diabetes Care. The [CGM] device does increase health care costs, but this is offset by the prevention of future costly complications, Elbert S. Huang, MD, MPH, FACP, professor of medicine, director of the Center for Chronic Disease Research and Policy, and associate director of the Chicago Center for Diabetes Translation Research at the University of Chicago, told Endocrine Today. In the 6-month DIAMOND trial, researchers randomly assigned patients with type 1 diabetes and HbA1c levels of at least 7.5% to a CGM group (n = 105; 45% women; 90% white; mean age, 45.7 years) or a control group (n = 53; 43% women; 94% white; mean age, 51.4 years). All patients provided information about their health-related quality of life, utilization of health services outside the study, medications, test-strip use, work productivity if employed, and daily hours spent on self-management diabetes care at baseline and 6 months. Researchers conducted an analysis on the cost-effectiveness of CGM both within the trial, using observed data, and over a lifetime, using a modified Sheffield type 1 diabetes policy model. At 6 months, the within-trial cost-effectiveness results showed an average total cost of $11,032 for the CGM group and an average total cost of $7,236 for the control group (P < .01). The difference in total costs stemmed predominately from the CGM device cost of $2,554, according Continue reading >>
Freestyle Libre Now Available In Major Us Pharmacies
FreeStyle Libre Now Available in Major US Pharmacies Abbotts no-calibration CGM availableat pharmacies like CVS and Walgreens for a cash price ranging from about $36-$53/10-day sensor; get cost and prescription details here Two months after approval by the Food and Drug Administration (FDA), Abbotts FreeStyle Libre (real time) continuous glucose monitor (CGM) is now on the shelves of major pharmacies in the US, including CVS, Walgreens, Walmart, Rite Aid, and Krogers/Smiths. The long awaited sensor finally comes to the US more than three years after it launched in Europe. Here are all the details on how to get one and what it costs. A prescription is required to get FreeStyle Libre in the US, and Abbotts website has a helpful prescription request form after filling it out with your information, Abbott will actually request a prescription from your healthcare provider. To help start a conversation with your provider, Abbott also has a discussion guide . Healthcare professionals can also visit Provider.FreeStyleLibre.us . How much does FreeStyle Libre cost? Does it have insurance coverage? US insurance companies, Medicare, and Medicaid do not yet cover FreeStyle Libre in the US, meaning people with diabetes will need to pay cash for it in pharmacies. Abbott has made the cash price of FreeStyle Libre less than other systems both for individual sensors and for the reader devices. Below are the price ranges at major pharmacies we called. In our research, FreeStyle Libre is the least expensive at Walmart, where each 10-day sensor is $35.99, and each reader device (one time purchase) is $69.99. Please note that diaTribe contacted individual pharmacies to get this information; prices at your local pharmacy may differ. 10-day Libre Sensor - $52.99 each (about $159 per month) 10 Continue reading >>
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Cgm Cost - Glucose Monitoring - Tudiabetes Forum
Im just wondering what the total cost of having a cgm is? I currently have a Medtronic cgm, without a pump, but Im looking to get a Dexcom. I know that a Dexcom needs a new transmitter every 3 months, but Im not sure what the cost for those is. Also, what are the costs of sensors? Thanks for your help. As always, it depends on your insurance. I recommend calling your insurance company to know for sure. As an estimate, I paid $1,000 copay for my Dex (I believe that total cost might be $5,000, including a transmitter, but no sensors). A new transmitter might be covered, but if something happens to it, when I have replaced them, it has been $1,000 (That might be my insurance cap on durable hardware out of pocket). For sensors, I pay around $300 per box, that might last me a couple months, but it depends on how often you use them. One way to cut back a little on Dexcom system CGM cost is to use the G4+Share version. G4 transmitters are under warranty for six months and often last 9-12 months. The G5 transmitters have a lifespan fixed in software. The G4 is just as accurate as the G5 and uses the same sensors. Is there a subscription plan in the States? They offer this in Canada, where if you sign a 12-month contract and buy 1 box of sensors every other month the G5 transmitters are $89/month and they give you a 7th box of sensors free. I consistently get 2 weeks out of a sensor and sometimes more, so 6 boxes is all I need for a year. Also, what is wrong with using Android? I didnt buy a G5 receiver, but been using the G5 with my Samsung Galaxy S7 for a week now and havent had any issues. If you get the G4 which is just as good imo unless you want Bluetooth etc. you need a new transmitter every 6 months. But mine lasted longer. The G5 transmitter dies at not long past the b Continue reading >>