Making Continuous Glucose Monitors available to members can improve health outcomes and decrease the total cost of care.
Anyone with diabetes knows how hard it is to manage – and how costly. While continuous glucose monitors (CGMs) help patients check blood sugars, they also add to the cost of care. Making CGM devices more affordable can help improve outcomes and pave the way to health equity.
The burden of diabetes
In the United States, more than 37 million individuals have diabetes, while 96 million have prediabetes. That’s 11% and 38% of the population, respectively. Poorer communities have higher rates of the condition, the American Diabetes Association (ADA) found.
Patients with diabetes can’t make enough or make proper use of insulin, the hormone that regulates blood glucose. Too much glucose in the blood can harm organs such as the eyes, kidneys, and heart. Left uncontrolled, diabetes can lead to heart attack, stroke, kidney failure, neuropathy, and the need for amputation.
How continuous glucose monitoring devices helps
Glucose monitoring provides insight on the effects of insulin doses and lifestyle. For complex patients with diabetes, self monitoring blood glucose isn’t enough. Not even the most diligent patients who self-monitor four to 10 times per day can provide the same insights with the same ease as a continuous glucose monitor.
For this reason, scientists sought a better way to monitor blood glucose. In 1999, the U.S. Food and Drug Administration (FDA) approved the first transdermal implantable glucose sensors. Today’s CGMs use a small sensor placed under the skin of the arm or stomach for continual monitoring of blood glucose levels.
The benefits of continuous glucose monitoring devices
CGMs are “essential” for creating the ambulatory glucose profile (AGP), a standardized snapshot of daily glucose and insulin patterns, according to the ADA.
CGM technology has these advantages:
- Gives more in-depth data on blood glucose levels than traditional blood glucose meters
- Can test every few minutes and send data to a monitor wirelessly, rather than requiring a patient to self-test many times a day
- Helps patients target their insulin dose and make lifestyle choices to achieve their health goals
Patients using CGMs have fewer instances of hypoglycemia and lower average blood glucose (A1c) levels. Given the inverse relationship of diabetes to household poverty levels, increasing access to CGMs can help advance health equity.
Providing access to continuous blood glucose monitors
Most insulin users don’t use CGMs, whether due to lack of access, provider awareness, affordability, or some combination of these reasons. CGMs can be hard to afford because they often fall under the durable medical equipment benefit.
By making CGMs available to members with diabetes, plan sponsors can help them achieve their health goals with a lower cost of care. Take these steps to encourage use:
- Include coverage of CGMs in plan offerings as part of a comprehensive approach to diabetes management
- Educate providers on the benefits to encourage prescribing
- Identify members who qualify for use and educate them on how to take advantage of them as part of their benefits
See how our solutions can help
SafeGuardRx Diabetes Care ValueSM
Diabetes Care Value, part of the value-based SafeGuardRx platform, proactively combats the rising prevalence and seemingly insurmountable costs of living with diabetes. It was designed to tackle the diabetes dilemma and all-to-often comorbidities, like high cholesterol, pre-diabetes and obesity, and continues to evolve today.