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Accessing medical technology for T1D: More than just availability

17 June 2015

Pump Silhouette with Enlite CGM screen mg versionInterest within the Australian community to improve access to medical technologies for the management of type 1 diabetes (T1D) is critical if we are to raise awareness on the importance of appropriate medical care and an ability to live well with T1D.

Improving access to medical technologies is more than simply having a therapy available in Australia. Access also relates to the ability to put the medical technology ‘in the hands’ of people who will benefit and use them. This often comes back to a matter of funding.

The funding platforms for insulin pump therapy and continuous glucose monitoring (CGM) sensors for management of T1D in Australia are not reimbursed for all people who would benefit from therapy. While some funding avenues are available for insulin pump therapy, there is currently nothing available for CGM.

CGM is the cornerstone of promoting good glucose control and has been available in Australia since 2007. It is the only available test method that can track glucose patterns of high and lows all day, every day, enabling individuals to fine tune their insulin requirements and so address glucose level extremes not identified by other methods. It is also fundamental to decreasing the gap between current treatments and the availability of an artificial pancreas.

Although a submission has been made to the Australian Government for subsidisation of CGM, the complexities associated with current funding pathways in government, mean that there is no predetermined ‘budget’ within which CGM sensor funding may be allocated – the technology is not considered a pharmaceutical therapy, or an implanted medical device, and therefore falls outside these two established sources for funding within the Budget. It is also not currently one of the product categories funded through the NDSS budget.

It is a complicated area, and highlights a significant gap in the approach Government takes to funding of medical technologies – particularly when you consider the desire to deliver healthcare solutions which are the most effective; less invasive; and, keep people out of hospital for longer.

The submission containing economic and clinical evidence for reimbursement of CGM technology can be found here: https://www.medtronic-diabetes.com.au/sites/default/files/CGM_sensor_reimbursement_Federal_Budget_Submission_2015-16_6-Feb.pdf.

One Comment leave one →
  1. John Douglas permalink
    18 June 2015 10:12 am

    Perhaps a genuine industry wide approach (beyond just MTAA) to changing the unfair & outdated diabetes technology funding platforms including: NDSS, Prostheses and the insulin pump grants would be a more successful approach. Government and Health Ministers may see this approach as non brand specific, a non partisan request and an alternative option to negotiating with health funds.

    Insulin pumps never belonged on the Prostheses List as they were not an “implanted” product, this concerned many health funds at the time. Successive Health Ministers have avoided changing the Prostheses funding as there are other larger Health Insurer challenges to negotiate.

    Diabetes Technologies in Australia needs a new and modern funding mechanism. While Health Funds should be part of the decision making they should not dominate it.

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