–JDRF Calls for CGM Medicare Coverage to Help Improve Health Outcomes Among Seniors with T1D and Advance an Artificial Pancreas–
Washington, D.C., July 30, 2014 – Today U.S. Senators Susan Collins (R-ME) and Jeanne Shaheen (D-NH), Co-chairs of the Senate Diabetes Caucus, introduced legislation to ensure that seniors with type 1 diabetes (T1D) who are Medicare eligible have access to continuous glucose monitors (CGM) as prescribed by their physicians. The legislation, S.2689, ‘Medicare CGM Access Act of 2014,’ will address the growing concern that people with T1D who are over the age of 65 cannot obtain coverage for a critical and potentially life-saving CGM device through Medicare, even if they used these technologies successfully prior to becoming Medicare eligible. In addition, this coverage would help pave the way for the next generation of CGM-related technologies, such as artificial pancreas systems.
The CGM is an FDA-approved, physician-prescribed device that detects and displays blood glucose levels continuously, and also reveal trends in a patient’s glucose levels that often go unnoticed by using finger-stick measurements alone. The CGM has been shown to improve glucose control. By viewing continuous data, and by responding to alerts from a CGM, patients can react to rising or falling glucose levels before they become dangerously high or low. The use of CGM technologies is recommended by national diabetes clinical guidelines and covered by nearly all private health plans, and thousands of people are benefitting daily from tighter glucose control reached with the help of a CGM.
“Five years ago, private health plans across the country started covering continuous glucose monitors, thanks to JDRF leadership in funding an independent CGM clinical trial and educating the health system about the results,” says Derek Rapp, president and CEO of JDRF. “Now we need Medicare to make these life-saving diabetes technologies available to seniors as well. JDRF is grateful for the bipartisan support of Congress for this issue of great importance to the type 1 diabetes community.”
The CGM has the potential to improve quality of care while reducing unnecessary expenditures. Obtaining health care coverage for CGM and artificial pancreas technologies remains a top policy priority for JDRF. The JDRF-funded CGM trial has shown that the rate of severe hypoglycemic (low blood sugar) events among adults using a CGM fell by two-thirds over the first year of use. Medicare beneficiaries with diabetes have disproportionately high hospitalization, emergency room use, and mortality rates, according to the Agency for Healthcare Research and Quality. Currently, costs for a hypoglycemia inpatient admission average $17,564 per visit, and overall, 42 percent of Medicare’s fee-for-service spending is attributed to people with diabetes. Diabetes is one the costliest chronic diseases accounting for $245 billion in economic costs in 2012 alone, including $176 billion in direct medical costs and $69 billion in reduced productivity. Of the $176 billion in diabetes-related medical costs, 59 percent or $104 billion is attributed to those aged 65 and older.
For more information about JDRF Advocacy efforts and continuous glucose monitor coverage by Medicare, please click here.
JDRF is the leading global organization funding type 1 diabetes (T1D) research. JDRF’s goal is to progressively remove the impact of T1D from people’s lives until we achieve a world without T1D. JDRF collaborates with a wide spectrum of partners and is the only organization with the scientific resources, regulatory influence, and a working plan to better treat, prevent, and eventually cure T1D. As the largest charitable supporter of T1D research, JDRF is currently sponsoring $568 million in scientific research in 17 countries. For more information, please visit jdrf.org.
# # #