The Journal of Medical Internet Research Diabetes has released a new study that presents important facts on Continuous Glucose Monitors (CGMs) and how they affect patient adherence as well as overall healthcare expenses. According to the study, those with diabetes who get their Continuous Glucose Monitors (CGMs) through the Durable Medical Equipment (DME) benefit had higher rates of adherence than those who buy them from pharmacies. Additionally, it demonstrates a significantly reduced total cost of treatment for those who are eligible for the DME benefit.
Synopsis of the Research
Leading the charge was CCS Medical, in conjunction with renowned medical experts from universities like North Carolina State University, Generativity Health Economics, and Outcomes Research, and the University of Rochester, this peer-reviewed study explored the impact of device sourcing on real-world adherence and cost implications of continuous glucose monitoring in patients with diabetes: retrospective claims analysis.
The need to comprehend the potential effects of various CGM delivery methods on patient behavior and healthcare outcomes drove the research. The prevalence of diabetes is rising worldwide, making it critical to develop efficient diabetes management strategies that improve patients’ quality of life. The goal of the study is to clarify the practical ramifications of where to get Continuous Glucose Monitors (CGMs) and how these choices may impact patients’ health.
Key Findings
The study offers convincing information that emphasizes how crucial device sourcing is for managing diabetes:
Higher Adherence Rates
Patients who received DME benefits were 23% more likely to use Continuous Glucose Monitors (CGMs) consistently than patients who received pharmaceutical benefits. This implies that a patient’s insurance coverage type has a significant impact on how frequently they use these gadgets. Because adherence is associated with improved blood glucose control and a lower risk of complications from diabetes, it is crucial.
Better Therapy Reinitiation
Among non-adherent patients, the DME benefit demonstrated a notably higher rate of therapy reinitiation (22%). By comparison, the pharmaceutical benefit had a reinitiation rate of only 10%. This is a crucial discovery because it shows that when Continuous Glucose Monitors (CGMs) are covered by the DME benefit, patients are more likely to start managing their diabetes effectively again. Higher reinitiation rates have the potential to improve long-term health outcomes and glucose management.
Savings
The analysis showed that the two groups’ healthcare expenses differed significantly. The mean yearly total medical costs for adherent patients receiving their Continuous Glucose Monitors (CGMs) through the pharmacy channel came to $10,635, which was 53% more than the $6,967 that the DME benefit-eligible patients paid. This data demonstrates how device sourcing can result in considerable cost savings for patients and the healthcare system, in addition to having an impact on patient adherence. Reductions in the overall expenses of healthcare can result from lower CGM usage costs, which is advantageous for payers and policymakers.
The Value of Constantly Checking Blood Sugar
Continuous Glucose Monitors (CGMs) are essential tools for managing diabetes. They give people access to real-time glucose data, empowering them to make educated decisions regarding their food, degree of exercise, and use of insulin. Continuous glucose monitoring makes it possible to respond quickly when blood sugar swings, assisting in the prevention of both hypoglycemia and hyperglycemia. However, patient adherence plays a major role in their efficacy. Patients lose out on the benefits of their Continuous Glucose Monitors (CGMs) if they don’t utilize them regularly, which might result in poor glycemic control and higher medical expenses.
“CGMs are only effective if people use them,” stated Dr. Arti Masturzo, Chief Medical Officer of CCS, underscoring the significance of these findings. This groundbreaking study shows how a doctor’s choice to advise a patient to use their medical benefit rather than their pharmacy benefit when obtaining a medical device can have a significant influence on both the patient’s health and the cost of care. This claim emphasizes how important it is to make strategic decisions when providing treatment for patients, especially when it comes to paying for necessary medical equipment. The study’s conclusions emphasize how important it is for medical professionals to help patients choose the best course of action.
Read Next: How to Get A Continuous Glucose Monitor OTC Without Diabetes
Consequences for Medical Professionals
The study’s conclusions are an essential tool for payers, policy supporters, and healthcare professionals. This study offers a solid foundation for conversations about insurance benefits and healthcare policy by showing the benefits of DME coverage for Continuous Glucose Monitors (CGMs). It pushes medical professionals to think about how device sourcing may affect patient adherence and general health outcomes in the long run.
Healthcare professionals should remind their patients of the value of utilizing DME benefits. This may entail informing patients of their choices and helping them to make well-informed decisions on the control of their diabetes. Providers could describe, for example, how DME coverage can result in improved access to essential medical equipment, which can enhance adherence and save healthcare costs.
Advocacy and Its Effects on Policy
Because of these new findings, it is imperative to advocate for the continuation of CGM coverage under the DME benefit. DME coverage is connected with significant cost savings and improved health outcomes, which policymakers and insurance companies need to acknowledge. Maintaining this benefit will encourage individuals to follow their diabetes management programs, which will improve their health and save costs for the healthcare system.
Furthermore, it is becoming more and more important to comprehend the implications of insurance benefits as the demand for Continuous Glucose Monitors (CGMs) rises. Ensuring that people have access to reasonably priced CGMs regardless of their insurance status can be the main goal of advocacy initiatives. The study’s findings can be utilized to convince interested parties that DME coverage for CGMs must be given top priority during legislative talks.
The Management of Diabetes in the Future
Technology’s significance in diabetes management is growing as it does. Patients are now better able to successfully control their diseases because of developments in continuous glucose monitoring (CGM) technology and the incorporation of data analytics. But these improvements won’t materialize until patients regularly use the equipment. Therefore, optimizing the advantages of Continuous Glucose Monitors (CGMs) requires promoting adherence by encouraging healthcare policies, education, and better insurance coverage.
Future studies on the efficacy of CGMs and patient adherence should provide more information that can guide the development of diabetes care best practices. The medical community can modify its tactics to better serve patients’ needs and address the difficulties they have in controlling their diabetes as more data becomes available.
In summary
To sum up, the research that was published in the Journal of Medical Internet Research Diabetes provides an important new understanding of the connection between patient adherence and CGM sources. Data unambiguously show that Continuous Glucose Monitors (CGMs) provided under the DME benefit contribute to significant healthcare cost reductions in addition to improving adherence rates. Healthcare professionals, decision-makers, and patients must emphasize the efficient management of diabetes with readily available, reasonably priced devices like continuous glucose monitoring (CGMs).
In the end, our results support improved insurance coverage tactics that enable individuals to take responsibility for their health and welfare. The management of diabetes in the future will depend on our capacity to promote adherence and provide the required resources to those who require them the most. We can improve patient outcomes, lower costs, and build a more effective healthcare system that meets the needs of people with diabetes by advocating for the DME benefit of Continuous Glucose Monitors (CGMs).
