The Centers for Medicare & Medicaid Services (CMS) announced that over 1,750 standalone Medicare Part D prescription drug plans and Medicare Advantage plans with prescription drug coverage have applied to offer lower insulin costs through the Part D Senior Savings Model for the 2021 plan year. Across the nation, participating enhanced Part D prescription drug plans will provide Medicare beneficiaries access to a broad set of insulins at a maximum $35 copay for a month’s supply, from the beginning of the year through the Part D coverage gap. The model follows on the Trump Administration’s previously announced 13.5 percent decline in the average monthly basic Part D premium since 2017 to the lowest level in seven years.
Improved Insulin Patch Could Replace Pumps, CGMs, and MDI. as reported by Sara Seitz for InsulinNation.com, 23 July 2020.
New insulin patch system utilizes fast, intermediate, and long-acting insulins in matrix materials to manage basal and meal glucose fluctuations. Thanks to research funded by the National Natural Science Foundation of China and published in Science Advances, we are closer than ever to an insulin patch capable of not only replacing the need for insulin pumps and injections, but that shows promise to even further reduce glucose fluctuations before and after meals.
Insulin patches consist of an integrated microneedle patch (IMP) prefilled with insulin. Similar to the Nicorette patch in size and wearability, the insulin IMP is placed on the skin, allowing hundreds of tiny needles to penetrate the subdermal layer and release insulin on an as-needed basis. Each needle array is constructed of a matrix material that reacts to the acidic nature of glucose in the blood and automatically releases insulin in response to rising blood sugar levels. Not only does this process allow for an insulin dosing pattern that more accurately mimics the function of a working pancreas, but it also erases the need for frequent blood sugar monitoring and manual needle injections.
Contrary to the immense complexity of artificial pancreas systems which need to analyze current glucose readings, past trends, insulin-on-board, time-of-day, etc., these glucose responsive patches are simple and will likely be safer.
Read more: Improved Insulin Patch
Researchers debate whether artificial pancreas systems should be single or dual hormone was debated at the virtual 80th Scientific Session of the ADA2020.
Dr. Hovorka said two principles make for a good artificial pancreas system—good glucose control (about 70% time-in-range) and low burden on the patient (11 to 20 minutes of use per day). “Insulin-only, closed-loop systems are suitable for the majority of people with type 1 diabetes,” Dr. Hovorka said. “While the dual-hormone field is catching up, the insulin-only field is not standing still—faster insulins, advanced algorithms, regulatory and reimbursement pathways, and cost pressure by payers. The dual-hormone system will need to catch up with these developments.”
Dr. Russell, Associate Professor of Medicine at Harvard Medical School and Associate Physician at Massachusetts General Hospital, said a bi-hormonal system has the potential to achieve lower glucose, longer time-in-range, and less hypoglycemia than a well-functioning insulin-only system. One of the biggest concerns with a dual-hormone system is that the second drug adds costs, both researchers noted, but Dr. Russell justified the cost. “This system can be manufactured in such a way that it doesn’t have to be more expensive and yet it adds substantial value,” he said. “The addition of glucagon would be justified by the improved outcomes, improved quality of life, and the ability to be more spontaneous around exercise that comes with having automated prevention and treatment of hypoglycemia.”