For patients with diabetes, use of glucose monitors depends on how they get them

More patients with diabetes are using continuous glucose monitors, but a new study finds that their ability to stick with the devices and use them properly is tied to how they get the devices.

Researchers find patients are more likely to continue using them if they get them from medical equipment providers rather than pharmacies. Dr. Arti Masturzo of CCS says it's important to meet patients where they are.

In a new study published in Clinical Diabetes, patients who receive continuous glucose monitors from durable medical equipment providers show better adherence than patients who obtain them from pharmacies. The findings were published this morning.

Patients getting their continuous glucose monitoring devices from medical equipment providers showed better adherence across different types of payers. While previous research has indicated better adherence with medical device suppliers, the new study shows advantages for patients on Medicare, Medicare Advantage plans and commercial insurance.

Those getting their devices from medical equipment providers also had a lower cost of care and spent less time in the hospital than those getting the monitors from pharmacies.

Arti Masturzo, MD, chief medical officer of CCS, a chronic care management company, tells Chief Healthcare Executive® that the study shows the importance of giving patients good instruction in using continuous glucose monitoring devices.

“When you look at how tricky these devices are, I don't think it's very surprising,” she says.

It takes time getting used to using the devices, and medical equipment providers are going to do outreach to make sure patients have the monitors and know how to use them, or can walk them through the process, she notes.

• Read more: Patients with diabetes need more than continuous glucose monitoring systems

The study found better adherence consistently among different groups of patients who received their monitors from medical equipment suppliers as opposed to pharmacies.

One year after getting the devices, patients on Medicare and Medicare Advantage had 78% adherence in using monitors from medical equipment providers, while those who received them from pharmacies had 64% adherence.

Among patients with commercial insurance, those getting devices from medical device suppliers had 60% adherence one year after getting their monitors, compared to 48% for those who obtained them from pharmacies.

Researchers also found adherence changing over time among patients with commercial insurance. While adherence was comparable for patients three months regardless of where they got the device, those getting monitors from medical device providers showed more adherence after six months and after a full year.

The study also found lower costs of care for those getting their devices from medical equipment providers. Patients on Medicare and Medicare Advantage getting monitors from medical equipment providers had total costs of $11,154, or $3,875 less than those getting the devices from pharmacies.

“There’s a saying that the most expensive medication or device is the one that sits in the cabinet,” Masturzo says.

“These devices are only good as number one, if you use them, and number two, if you know how to actually interpret the data, and change behaviors,” she adds.

Those obtaining continuous glucose monitoring systems from medical device providers also spent less time in the hospital. A year after getting the monitors, patients with commercial insurance who received them through medical device providers spent 8 days in the emergency department or the hospital. Commercially insured patients who got monitors from pharmacies spent 11 days in the hospital after one year.

The researcher said that the reduced costs are “likely attributable to improved clinical outcomes driven by greater adherence” to the continuous glucose monitoring devices.

Doctors often prefer having patients gets the devices through medical equipment suppliers to ensure that they get more support, but many are pressed to use pharmacies, according to a recent survey by CCS.

Masturzo says the point of the study isn’t to show payers that glucose monitors should only be provided by medical equipment suppliers.

“The point is that we should meet providers where they are,” she says. “We should meet patients where they are. We should create channel access that is individualized for the maximum impact benefit for that patient.”

“My hope is that this starts very fruitful and productive conversations with health plans to really anchor in I think what everybody cares about, which is patient outcomes and lowering costs,” Masturzo says.

The continuous glucose monitoring market is expected to continue to grow in the coming years, possibly reaching $20 billion by 2030, analysts say.

• Read more: Type 1 diabetes is a ‘nasty disease,’ and too many don’t realize it