It is very difficult to get NHS funding for a CGM, @
jagger38. Hypo unawareness is one of the criteria, but it is an uphill struggle. Running a CGM is expensive and this would have to come out of your GP's limited budget so they would need to be convinced.
By the way I can't get the sensors for £47. Where do you get them for that price @
davidlancaster? I am paying just under £65 each, in packs of four from Advanced Therapeutics, who I thought were the only supplier?
It's a good point about the cost of strips @
ElyDave, but keep in mind with a CGM you are still using a minimum of 2 strips a day, preferably 4 a day, to keep the sensor calibrated. You are also never supposed to make a treatment decision (including any insulin dose) without doing a finger stick test. Having used the CGM in real life I think this is good advice. So the economic argument isn't ten strips a day vs the sensor cost, it's ten strips (or whatever) vs the sensor cost plus maybe 4-6 strips. Still the sensor costs me about £6/day in practice (10 days average use) or officially about £9.25/day (7 days official use). I think strips for the most expensive meters cost the NHS about a quid each? So if you were consistently using more than 16 strips a day there would be an economic case for the NHS to fund CGM sensors (factoring in another £1/day for the transmitter and ignoring the purchase cost of the CGM, probably another £1/day over its operating lifetime).
Probably however your GP would just tell you to use fewer strips. I actually had mine phone me up telling me I was using too many strips. Partly because GPs just don't get T1 I think. But also because all GPs are under pressure to reduce their prescribing costs.
Because of the cost of the sensors I stopped using the CGM. I didn't realise that I would need a new transmitter every year whether I used it or not, so that was an unwelcome £380, and a waste of money on the first transmitter. All because the battery runs out. I thought they were going to swap the transmitter for free, recharge it at the factory, recondition it, send it out to someone else. That would be much too "green" I guess.
I am using the Dexcom G4 CGM again now that I have the Animas Vibe pump. Because of the cost I'm aiming to use it one week per month, or however long one sensor lasts. I use it to check my basal pattern and ratios are correct. It's also very useful for spotting if an infusion set has failed. I just had a very bad case of DKA caused by two infusion set failures in a row. The canula didn't insert properly. If I had been wearing the CGM I would have spotted the infusion set failure and avoided the DKA. To me that's a good argument for the NHS to fund CGM for every pump user. Of course equally you could say it's an argument to stay on MDI. The NHS is not made of money after all. I'm incredibly grateful for everything they do fund. We are so lucky.
