Study: Lower costs, higher adherence with CGM through medical benefits

According to a new study, patients with diabetes fare better when they receive a continuous glucose monitor (CGM) through a medical benefit instead of a pharmacy benefit.

The peer-reviewed research, conducted by CCS—a clinical solutions and home-delivered medical supplies provider—found that 35% of patients experienced lower average annual total costs of care and 23% higher device adherence.

The study was published in the Journal of Medical Internet Research Diabetes (JMIR Diabetes) and used data from 2,356 patients – 1,178 from the pharmacy cohort and 1,178 from the durable medical equipment cohort.

Arti Masturzo, chief medical officer, CCS

“Based on more than 30 years of serving people with diabetes, our team at CCS confidently believes patient education and coaching services provided by medical suppliers offering CGMs are precisely why patients fare better,” Arti Masturzo, MD, chief medical officer at CCS, told Access Insider.

Also reported, only half of patients using CGM technology say they received self-management education and support for diabetes.

“CGMs are only effective if people use them. The best way to ensure CGM utilization and longstanding adherence is to surround patients with trusted educational and coaching support services that empower patients to lead confidently in their journey with diabetes,” she continued.

Patients are facing reduced access to care due to staffing shortages and pharmacy closures, leading to diminished support from clinicians and pharmacists, she also noted. As a result, Masturzo believes the need for more investment in education and coaching for diabetes is necessary.

Meanwhile, total costs for adherent patients receiving CGMs through a pharmacy benefit was 53% higher.

The reason behind that is likely linked to increased utilization of high-cost healthcare services like the emergency room and hospitalizations due to lapses in CGM adherence, Masturzo told us.

“Challenges specific to CGM adherence are often accompanied by poor health outcomes, which can lead to patients being forced to seek out high-cost emergency care.”

For nonadherent patients who use CGMs, research showed a higher therapy re-initiation rate at 22% for patients using the medical benefit compared to those using the pharmacy benefit.

Masturzo added that early data show patients who are more adherent with a CGM are, in turn, also more adherent and engaged in other aspects of their care.

“We’re pursuing additional peer-reviewed research to understand better how stronger CGM adherence impacts the overall health and well-being of people living with diabetes,” she said.

“Today, the best way to get ahead of potential CGM adherence issues is to leverage emerging predictive models that support proactive risk stratification and outreach - and to invest in patient education and coaching tied to the CGM; medications; behavioral challenges, like diabetes distress, and ongoing lifestyle changes as well.”

DepositPhotos/VadimVasenin