PUBLISHED on 10/20/2015, Lilly’s LillyPad:
Today’s guest blog comes to us from Cynthia Rice, the Senior Vice President of Advocacy & Policy at JDRF. She is responsible for JDRF’s advocacy to Congress, the executive branch, regulatory agencies and health plans to accelerate life-changing breakthroughs to cure, prevent and treat type 1 diabetes and its complications.
For all people impacted by diabetes, timely monitoring of blood sugar levels can mean the difference between life and death. In recent years breakthrough technologies such as the Continuous Glucose Monitor (CGM) have transformed the lives of thousands of people with type 1 diabetes (T1D) by helping them gain tighter blood glucose control and prevent life-threatening complications.
CGMs are FDA-approved, physician-prescribed devices that provide real-time continuous information about current blood sugar, where it is trending and how quickly – which can often go unnoticed by using finger-stick measurements alone.
The efficacy and science behind this technology has been proven time and again to be a potential life-saver for people of all ages with T1D. Unfortunately, Medicare does not currently cover CGMs, leaving thousands of seniors vulnerable to severe life-threatening low or high blood sugar.
This is despite multiple clinical trials pointing to the overwhelming benefits of this technology. A JDRF-funded trial has shown that the rate of severe high blood sugar events among adults using a CGM fell by two-thirds over the first year of use. Not surprisingly, CGMs are recommended by national diabetes clinical guidelines and they are covered by nearly all private health plans.
The economic data alone are compelling – Medicare beneficiaries with T1D have disproportionately high rates of hospitalizations and emergency room use, often due to low blood sugar, which can result in seizures, comas or death. The cost of an average hospitalization for such an event is $17,500 per patient. A study found 16 percent of elderly patients with T1D had at least one seizure or episode of unconsciousness due to low blood sugar in the past year.
In addition, CGMs are an important component of an artificial pancreas, a system currently being studied in JDRF-funded research that combines a CGM with other technology to automate insulin delivery, a system that has the potential to revolutionize diabetes care.
Medicare’s refusal to cover the cost of CGMs has led to the introduction of the “Medicare CGM Access Act of 2015,” in the U.S. Senate (S. 804) and U.S. House of Representatives (H.R. 1427) by the bipartisan Diabetes Caucus to require coverage for CGMs for seniors. We urge Congress to act to ensure that the health of our loved ones doesn’t sunset at the age of 65. It’s time for Medicare to provide its beneficiaries with access to life-saving CGM technologies.