Diabetes in the news, in my life

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02/02/2017

CGMs are all around me. Ads for the Dexcom G5, in particular, keep popping up on websites. I am guessing this is because I Googled it while writing a story about Medicare’s recent decision to start paying for certain CGMs (the Dexcom currently being the only one that meets the criteria at this time).

I also met with a new CDE at the diabetes center this week. “Have you ever considered getting an insulin pump?” asked Sarah the CDE.

(Syringes are so 1980s.)

I get asked this every year or so. My reasons so far for deciding against the technology have been that I didn’t want to be tethered to it constantly; I wanted to wait a generation or so and see how much the technology improved (re: how much smaller the devices would get), and the costs.

Guess what? The devices are getting smaller and the technology has improved—most now seem to come with integrated CGM technology. Alas, I have a feeling the pricing for the device (hello, high deductible!) and the ongoing supplies would still be cost prohibitive for me.

I told all this to Sarah the CDE, but then we somehow (I may have brought it up) got on the topic of how Medicare is looking to cover CGMs, which could (possibly, maybe) ultimately lead to lower pricing across the board for diabetes tech.

When I got into the office, I Googled OmniPod because that’s what has interested me most in the past, and now I am getting pop-ups for that, too.

Unless Big Brother really is watching and somehow knows what I am thinking.

In the meantime, there are lots of details to be worked out for the Dexcom to get paid by Medicare. One interesting point (and correction, we transposed some numbers here) came to light today, from Greg at Applied Policy who has been working with Dexcom on this.

CMS has proposed a one-time payment of $236 - $277 for the CGM receiver.

I emailed him back to ensure I had understood correctly, and added that seems like an extremely low payment.

“That was our impression as well,” he told me.

Greg said it seems that CMS may have used historical data (they do love that historical data, don’t they?) for traditional glucose monitors. Those monitors cost far less than the thousands a CGM costs. For that matter, they also cost far less than $236 - $277, but I’ll save my rant about insurance pricing for another day.

As Greg told me, it’s a curious pricing mechanism, to say the least.

Finally, a story to put a smile on the face of anyone who uses insulin: a lawsuit was filed this week against the manufacturers accusing them of price fixing.

Stay tuned on all of the above.