Expanded medical device coverage for people with diabetes
British Columbians living with diabetes will now have the Dexcom G6, a continuous glucose monitor (CGM) that provides regular updates on blood glucose levels throughout the day, covered through BC PharmaCare.
“Thousands of British Columbians will benefit from coverage of continuous glucose monitors, which will allow patients to stay on top of their glucose levels with an easy, convenient system and will help patients and their health-care providers make better treatment decisions,” said Adrian Dix, Minister of Health. “We are grateful for the record number of British Columbians who provided input during our review of continuous glucose monitors. Your input is valuable and helps us determine what coverage is most beneficial to British Columbians.”
CGMs let people living with diabetes take control of their condition by automatically tracking glucose levels in real time. CGMs send regular readings of glucose levels to a device, such as a compatible smartphone or a reader, including push alerts when the patient’s blood glucose levels are outside a defined range. This enables patients or their caregivers to take action sooner, and helps protect people by empowering patients, caregivers and clinicians to identify glucose trends and adjust medications, activity and food intake.
With CGMs, a small sensor is attached to the skin on a patient’s abdomen or upper buttock. The Dexcom G6 sensor lasts 10 days before it must be replaced, and the Dexcom G6 transmitter can be used for 90 days.
These devices are expected to benefit almost 20,000 British Columbians each year in the first three years. At list price, it would have cost approximately $100 million over three years to implement coverage for the Dexcom G6 CGM. The Province successfully negotiated a discount.
The Dexcom G6 CGM will be a limited-coverage benefit, meaning coverage is available to people with diabetes who meet the special authority criteria for CGMs. For patients who receive special authority approval, coverage will be provided to people enrolled in Fair PharmaCare and to those with PharmaCare coverage through Plan C (income assistance), Plan F (children in the At Home program) or Plan W (First Nations health benefits).
On average, over 29,000 people are diagnosed with diabetes every year in British Columbia. Diabetes affects the body’s ability to regulate blood glucose levels. The complications of poorly controlled diabetes range from acute (e.g., fatigue, ketoacidosis and seizures) to chronic (e.g., nerve and organ damage). In Canada, diabetes is the sixth leading cause of death, and the leading cause of blindness, end-stage kidney disease and non-traumatic amputation.
PharmaCare continues to improve access to the medical devices and prescription drugs that British Columbians need. In January 2019, B.C. made a $105-million investment over three years to reduce and/or eliminate Fair PharmaCare deductibles and co-payments for lower-income British Columbians.
Special authority grants coverage to a drug, medical supply or device that otherwise would not be eligible for full coverage. British Columbians are encouraged to register for the income-based Fair PharmaCare drug coverage plan.
Dr. Shazhan Amed, head, endocrinology division, BC Children’s Hospital –
“As a doctor who cares for children and youth living with diabetes, I am thrilled about this announcement from the Ministry of Health that will provide public medical coverage of glucose sensors. This will make a huge difference in the quality of lives of people living with diabetes and strengthen my ability to provide the best care possible to all of my patients, regardless of their insurance coverage or household income.”
Dr. David Miller, endocrinologist, Victoria –
“Today’s announcement is good news for people in B.C. with Type 1 and other forms of complex diabetes. I commend the government and advocates for helping to bring continuous glucose monitoring technology to BC Pharmacare. This technology can help to protect people from insulin-induced, dangerously low blood sugars. It can also help to improve overall management of diabetes, reducing the risk of long-term, debilitating, expensive complications. I look forward to helping many of my patients integrate this newly available technology into their treatment plan.”
Dr. Colleen Nugent, pediatric endocrinologist, Tri-Cities Pediatric Diabetes Centre –
“The Ministry of Health’s decision to provide coverage for revolutionary, but often unaffordable, continuous glucose monitoring technology will benefit thousands of people who live with diabetes in British Columbia. Day-to-day diabetes control will be improved, and severe hypoglycemia and diabetes-related health complications will be reduced. Children and youth will no longer have to poke their fingertips with a needle six to 10 times a day to test their blood sugar levels, and parents and caregivers will be able to sleep through the night, knowing their child is safe and monitored.”
Ramya Hosak, founder, Young and Type 1 –
“Living with Type 1 diabetes (T1D) is like having a second full-time job, one that is invisible. The physical and emotional impact of a sudden high or low blood sugar impacts both your day to day life and potential long-term complications, a fear we live with every day. As someone who lives with T1D and is also married to a fellow T1D, I know the toll this takes over time on an individual and their loved ones. I also know the priceless relief a CGM system can bring to a family, such as knowing you will be alerted to you or your loved one’s dangerously low or high blood sugar during the night while sleeping. The CGM represents to me the best possible tool for us to stay safe and monitor our blood sugars in real time, ultimately preventing long-term devastating complications we hear about every day. Today’s announcement is so exciting, as it removes a huge financial barrier for our community to accessing this life-changing tool. This ensures that those living with Type 1 diabetes have access to the best care possible, no matter their financial background.”
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