A Major Worry and then a Win for Blood Glucose Monitoring and CGM at Controversial Technology Assessment Meeting

In late March in Olympia, Washington, a committee of 11 doctors (in policy parlance, a “technology assessment committee”) voted on Washington State’s coverage for blood glucose monitoring and for CGM for children 18 and under with diabetes. At risk was not only reimbursement for children in that state but the creation of a dangerous precedent for other states in their reimbursement of diabetic supplies. The thinking went – if Washington State cuts payments, so will the rest of the US. In considering reimbursement coverage, Washington State’s technology assessment committee asked how well blood glucose monitors worked, how safe they were, and how cost-effective they were. Those questions were also asked for CGM. There had been fears that reimbursement for blood glucose monitoring would be declined (this had been the original request), but the committee’s decision sustained strong coverage for the practice – a signature victory for the importance of blood glucose monitoring. Not only did the committee decide to rebuff attempts to reduce coverage (strips are unlimited – whatever these children need they will receive), they opted to cover CGM for kids who have had severe hypoglycemia. CGM coverage for kids didn't exist in Washington prior to this meeting. The coverage will not likely be limited since severe hypoglycemia is very common in children. diaTribe Advisory Board member Dr. Irl Hirsch of the University of Washington told the committee: "Don't mix up evidence-based medicine with ignorance-based medicine." And they didn't. Hurrah!  –KC