ManagedCareCGM

Continuous Glucose Monitoring

Education for Managed Care, Pharmacy, and Payer Professionals

Current Eligibility Requirements for CGM Coverage Are Harmful, Costly, and Unjustified

Source: Diabetes Technology and Therapeutics

Key Takeaway: There is growing and compelling evidence that CGM coverage should be offered to all patients who can benefit from this technology regardless of diabetes type and history of SMBG use. The current restrictions, which are based on outdated evidence and questionable assessments, are not supported in the literature. Moreover, they ignore the burden frequent SMBG places on individuals. Given the growing prevalence of diabetes, the persistent preponderance of individuals with suboptimal glycemic control, and the exorbitant and largely preventable cost of diabetes complications, opinion-based constraints should not continue to supplant evidence-based clinical management.