Diabetes Patients Not Buying Supplies Due to Costs

Many patients with diabetes are put off buying necessary supplies such as continuous glucose monitors (CGMs) and test strips due to their cost, a new study says.¹

According to the American Diabetes Association (ADA) survey of nearly 3000 diabetes patients, 1 in 5 say they have forgone or put off getting a pump or CGM. For half of them, it was due to financial strain.

In addition, 15% of diabetes patients delayed refilling needed supplies during the pandemic. The reason listed for the majority (70%) was financial strain.

Plus, around 31% of diabetes patients said they do not self-monitor glucose levels because blood glucose monitoring test strips were too expensive, and 47% reported that they did not self-monitor glucose levels because testing was not convenient.

The study illustrates the “significant barriers that low-income Americans, people of color, older Americans, and people with diabetes living in states with the highest prevalence of the disease face in accessing CGMs,” the ADA said in a news release.²

“These barriers are especially high for Americans on Medicaid, who are the least likely to have access to a CGM,” the ADA added. The devices provide “significant, potentially life-changing benefits for diabetes management, and in turn for the avoidance or delay of serious co-morbidities, hospitalizations, and even death.”

The ADA also found race and income disparity gaps when utilizing CGMs. Individuals enrolled in Medicaid who take insulin are 2 to 5 times less likely to use a CGM than those who have a commercial health insurance plan. “This coverage gap is less pronounced when only white individuals with Medicaid coverage are considered,” the ADA said.

States with higher rates of White Americans enrolled in Medicaid have a higher CGM use than states with higher rates of Black Americans, where Medicaid coverage of CGMs is “abysmally low,” the ADA noted. Hispanic individuals are also less likely to get a CGM if they are covered by Medicaid than a commercial health insurance plan.

“It is disappointing to see that access to vital diabetes management tools like CGMs often depends on your income, the color of your skin, your age, and where you live,” said Dr. Robert Gabbay, chief scientific and medical officer at the ADA. "The ADA is committed to addressing access barriers—such as inadequate health insurance coverage, steep Medicare and Medicaid coverage requirements, and physician shortages—to ensure that everyone who can benefit from a CGM can get one.”

The ADA said is working with the Centers for Medicare and Medicaid Services, state Medicaid programs, and Congress to eliminate barriers people face in accessing diabetes technology like CGMs.

References

1. Health equity and diabetes technology: A study of access to continuous glucose monitors by payer and race executive summary. American Diabetes Association. Accessed November 7, 2022. https://diabetes.org/sites/default/files/2021-11/ADA-CGM-Utilization-White-Paper.pdf
2. American Diabetes Association statement on new CGM study findings. News release. ADA. November 2, 2022.Accessed November 7, 2022. https://diabetes.org/newsroom/official-statement/2022/american-diabetes-association-statement-on-new-cgm-study-findings.