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Freestyle Libre 3

Discussion in 'Ask A Question' started by DavidDK, Apr 21, 2022.

  1. DavidDK

    DavidDK Type 1 · Well-Known Member

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    Hello

    Has anyone in the UK had a meeting with their diabetes consultant yet to discuss whether they should have the Libre 3?

    If yes, how did the meeting go?

    Was it difficult or easy to persuade your consultant that you should have the Libre 3?

    If your consultant said you couldn't have the Libre 3 what reason(s) did they give?

    Are you using the Libre 3 right now? If so, what are your first impressions of it?

    Do you miss having to scan your sensor once every 8 hours?

    How are you coping with the extra data the Libre 3 sensor gives you? Is it overwhelming?

    Have any of your Libre 3 sensors failed? If yes what happened?
     
  2. jaywak

    jaywak Type 1 · Well-Known Member

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    Libre 3 you must be joking ! i've been in touch with Drs , consultants , diabetes clinic only to be told that my finger prick control is good enough for there not to be any benefit in me changing to a libre 2 even , and if they were to put me on the list for receiving one it would be a very long time !
     
  3. In Response

    In Response Type 1 · Well-Known Member

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    @DavidDK can you provide some background to your questions?
    Have you had a bad experience when you requested Libre 3 or are you preparing your case for when you do?
    Libre 3 has not been available for long and the NICe guidelines are new without time for many CCGs to adjust their budgets to finance CGMs.
    Bear in mind, Type 1 care is a postcode lottery so the experience of someone in London maybe completely different to someone in Yorkshire, for example.
    You also say “UK” but the guidelines are different for each of the nations. The recent NICe guidelines only apply in England.
     
  4. DavidDK

    DavidDK Type 1 · Well-Known Member

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    No I haven't had a meeting with my consultant yet, and won't until later this year (the pandemic is still playing havoc with appointments where I live).

    I want to get a sense of how difficult the NHS are going to make it to access the Libre 3 if a patient thinks they're eligible. Or indeed, any other CGM as per the new guidelines.

    If one looks at the new NICE guidelines and the immediate previous guidelines, objectively it ought to be significantly less difficult to access a CGM proper, especially if one is T1.

    Some of us must be eligible to get the Libre 3, or a.n. other CGM, otherwise the new NICE guidelines become meaningless words on a page.

    I want to understand just how far the NHS is going to act as a gatekeeper to prevent those eligible from accessing the technology and the grounds on which they might exercise a gatekeeper function.

    In light of jaywak's kind response I am already pondering: if I meet my consultant later this year and ask for a Libre 3 on the basis I meet one or more of the various eligibility criteria in the new guidelines, and my consultant says to me "your glucose control is fine, you can stay as you are," is it reasonable for my consultant to do so? Particularly in light of the new guidance, and the clear emphasis in the new guidance that if one meets the criteria the patient's individual "preferences, needs and characteristics" should decide the type of device one gets.

    I can then decide whether or not I want to escalate the matter.

    Of course, it is trite to say that access to healthcare in England is - alas - subject to a postcode lottery. I get that. But as in other walks of like, NHS decision makers across England do talk to each other and formulate policy.

    Yes, apologies! I should have said "has anyone in England...." I realised after I pressed "send" I had extended it to the entire UK.

    My understanding is if a patient is given the Libre 3 (or any other CGM proper in accordance with the new guidelines) it will be funded from hospital trust budgets and not CCG budgets as one's consultant has to greenlight the use of a CGM.
     
  5. DavidDK

    DavidDK Type 1 · Well-Known Member

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    I'm very sorry to hear that jaywak. I assume you were keen to use the Libre 3.

    It doesn't seem right that one's glucose control needs to be poor to be eligible for this device.
     
  6. Jaylee

    Jaylee Type 1 · Moderator
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    Hi @DavidDK ,

    The libre 3 (to the best of my knowledge is only available right now in Germany..?

    It’s only possible to gain access to the libre 2 in the UK. The libre 3 will come in good time, as the L2 did.

    the L2 (which also started roll out in Germany.) is still a useful tool. I’m sorry with your struggle @jaywak . It took me a fair bit of pushing for a couple of years to get funding..
     
  7. DavidDK

    DavidDK Type 1 · Well-Known Member

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    Hello Jaylee

    Thanks for your reply. With all due respect, unless I have misread various press releases issued by NICE, NHS England and interviews given and tweets put out by the NHS England co-lead for diabetes technology at the end of March/beginning of April this year, the Libre 3 (and any other cgm proper) is available from 1 April 2022 in England to those T1s (and some T2s) who meet the new NICE eligibility criteria, following a discussion with their consultant via an NHS hospital trust.

    What one can't do (at present) in England is buy the Libre 3 privately from Abbott.

    Unless I misunderstood Jaywak's earlier reply, I assumed he has had the conversation with the clinicians who look after him. I assume they told him the product is available on the NHS but they have deemed him ineligible to receive the product at present.

    Of course, please tell me if I have lost the plot.
     
  8. Jaylee

    Jaylee Type 1 · Moderator
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    Hi, don't worry. I have to admit I get lost with Abbott's saga..

    From what I know with the libre 3 release. The folk reviewing at present are getting them in Germany. There is a guy from Poland did an informative vlog on YouTube too..

    The libre 2 when released started in Germany too from memory.. I had to wait a while longer in the UK before I got my mits on one..

    I now have them funded & prescribed. Though it did take some "sales pitch" to close the deal with my endo.
    Alas, knowing the historical roll out with the L2.
    The libre 3 may need the same patience.
    We may have our European community commonly using them before we do...
     
  9. EllieM

    EllieM Type 1 · Moderator
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    Maybe I'm being overly cynical but the new NICE guidelines, awesome though they are, are dependent both on the local health authority prescribing/paying and on Abbott having the capacity. I feel everyone will be in a much better place in a year's time but I wouldn't hold my breath till then.
     
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  10. Jaylee

    Jaylee Type 1 · Moderator
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    I find Abbott's roll out on a new product bizarre.
    When the Libre 2 happened, there was no real fanfair on the Abbott UK site?? It was only when I walked into the pharmacy I sourced the L1s from at the time I was offered the choice of the MK2?? Then I noticed a week or 2 later, Abbott was promoting on their site.. (& a bit later there was the free trial..)
     
  11. Speedbird

    Speedbird LADA · Well-Known Member

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    If someone would just clarify for me, before I barge my way into the DN’s office, am I right in thinking that the Libre3 has to have consultant approval, whereas the Libre2 can be authorised by the GP?
    Many thanks.
     
  12. Jaylee

    Jaylee Type 1 · Moderator
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    Hi,

    You need consultant approval for the L2 so your GP can put them on repeat script? Which is how it was for me.. The L3?? Could be a bit of a wait before the NHS has caught up...
     
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  13. DavidDK

    DavidDK Type 1 · Well-Known Member

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    Hi Jaylee.

    Thank you for your earlier replies.

    Once again, please do forgive me but unless I have gone completely doolally (which is always possible), Professor Partha Kar, who is the NHS England co-lead on diabetes technology confirmed at the end of March that some of us - IF we meet the new NICE criteria effective from 1 April 2022 - may be eligible to have a real time CGM (which includes, but is not limited to, the Libre 3).

    Professor Kar indicated that the new changes would take time to feed through the system, but T1s (and T2s) who believe they might meet the new criteria should discuss the matter the next time they have an appointment with their diabetes consultant.

    Anyone who is given a CGM proper following a meeting with their consultant, that CGM will be paid for out of the hospital trust budget and not the CCG budget.

    I see a hospital diabetic consultant and they look after my diabetes needs, so I will have the conversation with that person, not my GP.

    Yes, apparently at present in Europe, Abbott do distribute the Libre 3 (and I believe the Libre 1 and Libre 2) out of their German distribution hub (despite the fact that the libre was invented in the UK), but that should have no bearing on the availability of the Libre 3 in England if a patient is eligible according to the NICE criteria.

    I am not saying every T1 (or T2) will be eligible for a CGM. We won't. But my understanding from what I have read by the gentleman who got NICE to change their criteria is that we should at least be having a conversation with our diabetic consultants at our next appointments concerning eligibility (and preferences if eligible), as the consultant is the only person who can authorise use of a CGM (if eligible).

    For the time being, GPs won't be able to prescribe the Libre 3.

    Professor Kar also indicated that following the new NICE criteria, those T1s (and T2s) who aren't currently using either a flash glucose monitor nor a continuous glucose monitor may want to consider with their attending diabetic clinicians whether they would benefit from having a flash glucose monitor.
     
  14. DavidDK

    DavidDK Type 1 · Well-Known Member

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    Hello Ellie, you have every right to be cynical. I am fascinated to see just how many of us qualify for a cgm proper now the criteria have been changed.

    That said, my understanding is that IF a patient is eligible for a real time cgm, it will be paid for from hospital trust budgets, not clinical commissioning group budgets (which is why a hospital consultant has to sign off and one's GP can't prescribe the Libre 3 or any other cgm for the time being).

    As for whether Abbott has the capacity to crank out enough Libre 3s, I don't know. But it would be foolish if they can't given the fanfare that's been made in the healthcare press (and some national newspapers) in England of it being available.

    I guess there are other cgms who will be more than happy to take market share off of Abbott if they don't deliver.
     
  15. Hopeful34

    Hopeful34 Type 1 · Well-Known Member

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    I qualified for a cgm a few years ago, Consultant wanted to prescribe it, but CCG said they wouldn't fund it, so I never got it, despite repeated applications from the Consultant. Eventually I got Libre prescribed by the Consultant and collected at the hospital. This was then moved to the GP about a year or so later. Now getting Libre 2.
     
  16. DavidDK

    DavidDK Type 1 · Well-Known Member

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    Thanks Hopeful34.

    As I've said, my understanding (and I am more than happy for someone to tell me I have got this wrong) is that as of 1 April 2022 the funding for a real time cgm comes out of the hospital trust budget, not the GPs budget (which is effectively the clinical commissioning group budget).

    Historically CCGs/GPs have always been reluctant to fund real time cgms because they have been expensive.
     
  17. Jaylee

    Jaylee Type 1 · Moderator
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    No need to apologise. :)

    I feel there is a conflict regarding what was published by Partha K & what Abbott's marketing plan is worldwide regional with the libres..

    To date MK3 isn't in stock in the UK.

    The Libre 2s are what we have now.
    Incidentally. When my GP found out I was self funding my libres he was keen I was funded. But his hands were tied. He certainly banged em on script as soon as my endo contacted him..

    Without sounding too cynical. I tend to take what PK publishes with a pinch of salt?
     
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  18. Speedbird

    Speedbird LADA · Well-Known Member

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    Thank you.
     
  19. DavidDK

    DavidDK Type 1 · Well-Known Member

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    Thanks Jaylee.
     
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