Libre 3 on prescription...

[Blanchoid]

Hi all,

I have just been to my Diabetic Nurse (DSN) and I have to say the team I see are great about the only people in the NHS that need a pay rise... a story for another time!

The team had said when I queried about the Libre 3 that it is not available on the NHS due to cost, whilst the Dexcom One I am using is perfectly fine it does have its shortfalls, below I will list these:

Dexcom One
Initialization time: 2 hours
Duration of the sensor: 10 days
Size: considerable larger than a Libre 3
Packaging/Applicator: is huge, transmitter is added after application
Available on NHS: YES

Apart from these it works exactly as it should no having to scan with a reader or phone like Libre 2, which sometimes misses and you have to wait 10 minutes before trying again.

Libre 3
Initialization time: 1 hours
Duration of the sensor: 14 days
Size: tiny and thin
Packaging/Applicator: a single package, transmitter is included in applicator
Available on NHS: NO

This should work as good as the Dexcom One but I have not tested this so any thoughts would be appreciated. But it looks like the Libre 3 wins on the three most important counts.

My team was happy with the technology that is available to diabetics and said in my case it works and my recent results have proven this and that the NHS should remove all of the bureaucracy as diabetics know what works for them and what does not.

The team had also indicated that this was down to cost, to which I replied why don't I get the opportunity to pay the difference in price between the two, which would be way below £50. Th NHS is dictating to us what we can have and they should not!

My team suggested that I contact my local MP and explain this to him!

 

[BadaBing]

Hi all,

I have just been to my Diabetic Nurse (DSN) and I have to say the team I see are great about the only people in the NHS that need a pay rise... a story for another time!

The team had said when I queried about the Libre 3 that it is not available on the NHS due to cost, whilst the Dexcom One I am using is perfectly fine it does have its shortfalls, below I will list these:

Dexcom One
Initialization time: 2 hours
Duration of the sensor: 10 days
Size: considerable larger than a Libre 3
Packaging/Applicator: is huge, transmitter is added after application
Available on NHS: YES

Apart from these it works exactly as it should no having to scan with a reader or phone like Libre 2, which sometimes misses and you have to wait 10 minutes before trying again.

Libre 3
Initialization time: 1 hours
Duration of the sensor: 14 days
Size: tiny and thin
Packaging/Applicator: a single package, transmitter is included in applicator
Available on NHS: NO

This should work as good as the Dexcom One but I have not tested this so any thoughts would be appreciated. But it looks like the Libre 3 wins on the three most important counts.

My team was happy with the technology that is available to diabetics and said in my case it works and my recent results have proven this and that the NHS should remove all of the bureaucracy as diabetics know what works for them and what does not.

The team had also indicated that this was down to cost, to which I replied why don't I get the opportunity to pay the difference in price between the two, which would be way below £50. Th NHS is dictating to us what we can have and they should not!

My team suggested that I contact my local MP and explain this to him!

@Blanchoid my understanding is that the NHS (in England) have no legal mechanism to allow any patient to "pay the difference" in cost between what the NHS are willing to pay for a medical device (or drug) and the price the manufacturer of that medical device (or drug) wants for the product. For that to happen Parliament would need to change the law (and I doubt our politicians are going to do that any time soon given other priorities they are focusing on right now. Although I doubt they would do so in any event).

The Libre 3 is not available at present for GPs to prescribe "normally" on general prescription. Abbott have not made an application for the Libre 3 to be made available for "normal" prescription.

On another thread on this forum someone was told by their consultant that a 12 month supply of Freestyle Libre 3 sensors costs the NHS £1,800. If that is correct, each Libre 3 sensor costs roughly the same at the moment as a Dexcom G6 sensor.

12 months supply of Freestyle Libre 2 sensors or Dexcom One sensors cost the NHS roughly £840-£900.

 

[BadaBing]

Someone has posted on Facebook this morning that from mid-july 2023, and following a software update to Librelink, the Freestyle Libre 2 sensor will become a real time continuous glucose monitor giving minute-by-minute readings on compatible smartphones.

Apparently, the updated Librelink app will also allow glucose readings to be sent to compatible smartwatches (presumably without the need to use non-Abbott authorised third party apps).

Apparently, Abbott should be communicating this to Libre 2 users over coming weeks.

 

[lawrence21360]

@Blanchoid my understanding is that the NHS (in England) have no legal mechanism to allow any patient to "pay the difference" in cost between what the NHS are willing to pay for a medical device (or drug) and the price the manufacturer of that medical device (or drug) wants for the product. For that to happen Parliament would need to change the law (and I doubt our politicians are going to do that any time soon given other priorities they are focusing on right now. Although I doubt they would do so in any event).

The Libre 3 is not available at present for GPs to prescribe "normally" on general prescription. Abbott have not made an application for the Libre 3 to be made available for "normal" prescription.

On another thread on this forum someone was told by their consultant that a 12 month supply of Freestyle Libre 3 sensors costs the NHS £1,800. If that is correct, each Libre 3 sensor costs roughly the same at the moment as a Dexcom G6 sensor.

12 months supply of Freestyle Libre 2 sensors or Dexcom One sensors cost the NHS roughly £840-£900.

is this of a special rate for the nhs because ive just paid £110 for a month

 

[barrym]

Someone has posted on Facebook this morning that from mid-july 2023, and following a software update to Librelink, the Freestyle Libre 2 sensor will become a real time continuous glucose monitor giving minute-by-minute readings on compatible smartphones.

Apparently, the updated Librelink app will also allow glucose readings to be sent to compatible smartwatches (presumably without the need to use non-Abbott authorised third party apps).

Apparently, Abbott should be communicating this to Libre 2 users over coming weeks.

Wow. Not before time.

I emailed them 18 months ago when I started using Juggluco on L2, to siggest that they make use of the minute by minute alarm signal as a CGM indicator. All it needed was a figure displayed somewhere. Didn't have to be pretty. But eventually it looks like they're going to do it properly.

Can't help thinking it's a self defence stance in the face of all the competitive software exploiting this feature. Maybe wrong.

 

[BadaBing]

is this of a special rate for the nhs because ive just paid £110 for a month

Sorry @lawrence21360, I don't understand the question you're asking. What, precisely, have you paid £110 for?

Wow. Not before time.

I emailed them 18 months ago when I started using Juggluco on L2, to siggest that they make use of the minute by minute alarm signal as a CGM indicator. All it needed was a figure displayed somewhere. Didn't have to be pretty. But eventually it looks like they're going to do it properly.

Can't help thinking it's a self defence stance in the face of all the competitive software exploiting this feature. Maybe wrong.

I imagine Abbott became concerned for their future UK sales when Dexcom brought out the Dexcom One, which is real time cgm but a stripped down version of the G6 (and still only 10 days wear time), and when the NHS insisted the Dexcom One be available on prescription.

Smart move by Abbott. It's just a shame it took so long.

If this happens, presumably the Libre 2 can now be part the whole hybrid closed loops mix in England.

I wonder now what purpose the Freestyle Libre 3 will serve? Yes it's smaller than other cgms, but most knowledgeable commentators have questioned whether it really is significantly more accurate than the Libre 2 or competitor cgms (I understand the MARD testing done for Libre 3 was conducted significantly differently to the Libre 2 or competitor cgms which is supposed to have yielded the Libre 3 with a 7.9 MARD result).

I also agree completely, IF this LibreLink update does what has been suggested and also allows Libre 2 data to be ported directly to commercially available compatible smartwatches, I would expect Abbott to enforce their intellectual property rights against unauthorised third party apps.

 

[ftt1960]

Is there anybody here who receives a CGM on prescription but is not T1? I am currently free trialing the Libre2 and love it. I m MODY, so don't expect I'll be given a CGM on prescription.

 

[DEBBIESCOTT]

Is there anybody here who receives a CGM on prescription but is not T1? I am currently free trialing the Libre2 and love it. I m MODY, so don't expect I'll be given a CGM on prescription.

I’m MODY too
2 years ago my then DN gave me one to trial & told me I’d get it on prescription until they found out what was wrong with me (nobody would believe what I was eating & what meter readings were)
Last year after a confirmed MODY diagnosis my consultant upgraded me to libre 2 for the alarms
I’m on 20mg gliclazide a day & have to eat 6 times a day else I hypo
Without the gliclazide blood sugar would be high teens
If you have a DN or consultant it’s worth asking, I suppose it depends where you live, medication & blood sugars
Good luck

 

[Blanchoid]

Is there anybody here who receives a CGM on prescription but is not T1? I am currently free trialing the Libre2 and love it. I m MODY, so don't expect I'll be given a CGM on prescription.

I am Type one but my friend is Type 2 and he is on Libre 2, but he is entitled to a Dexcom One on prescription, according to NICE guidelines,

If you really want this you need to ask and push your DSN for this!

 

[Kelz7683]

Hi can anyone give me any info regarding CGM’s (although I admit I’m assuming these are the monitors you wear as opposed to the finger prick monitors). I am quite new to all of this initially diagnosed as T1 due to my HBA1C reading being 144 which I now have down to 54 and 4 rounds of blood tests showing no T1 indicators. They have now diagnosed me as T2 but I am still on insulin along with metformin. I am really bad for not eating much throughout the day as I have been used to eating 1 meal a day for so long it’s become habit and is hard to break although I know I need to. Because of that I am also not very good at remembering to check my blood sugars. Is there anyway a T2 is able to receive a CGM on prescription? Or are they for T1 only?

 

[Blanchoid]

Hi can anyone give me any info regarding CGM’s (although I admit I’m assuming these are the monitors you wear as opposed to the finger prick monitors). I am quite new to all of this initially diagnosed as T1 due to my HBA1C reading being 144 which I now have down to 54 and 4 rounds of blood tests showing no T1 indicators. They have now diagnosed me as T2 but I am still on insulin along with metformin. I am really bad for not eating much throughout the day as I have been used to eating 1 meal a day for so long it’s become habit and is hard to break although I know I need to. Because of that I am also not very good at remembering to check my blood sugars. Is there anyway a T2 is able to receive a CGM on prescription? Or are they for T1 only?

According to NICE guidelines you should be able to get a Dexcom One, which is what I am on (this should apply to all Type 1 and Type 2 diabetics).

According to "Type 2 diabetes in adults: management Section 1.6.17" (NICE guideline [NG28] Published: 02 December 2015 Last updated: 29 June 2022)

This all changed last year, apparently...

Though apparently the Libre 2 is also now CGM, I was on these but have been happy with the Dexcom, as it seems to be more accurate and it if loses connection it doesn't take that long to reconnect.

So I would go back to your DSN or Doctor and tell them this! And ask them to look, whilst you are sitting there!

 

[Kelz7683]

Thankyou so much for your reply. I’m having a nightmare trying to even get an appointment with my DSN. Everytime I get one it gets cancelled everytime I go back to my GP about it which is no mean feat they just refer me back to them as urgent and the cycle continues! The information I seen regarding access to one if you are type 2 came with conditions such as having recurrent hypos, having impaired hypo awareness, you have a condition or disability that stops you from being able to self test via finger prick or you have to self measure at least 8 times a day. None of those apply to me however when I do manage to get an appointment I am forever getting in trouble for lack of readings which I know are really important, I do a minimum of 3 a day which is alongside when I take medication but ideally they want at least 6! I will try my DSN again today and see if I can book another appointment and wait for the appointment to arrive without being cancelled although I won’t hold my breath!

 

[pcarl]

Someone has posted on Facebook this morning that from mid-july 2023, and following a software update to Librelink, the Freestyle Libre 2 sensor will become a real time continuous glucose monitor giving minute-by-minute readings on compatible smartphones.

Apparently, the updated Librelink app will also allow glucose readings to be sent to compatible smartwatches (presumably without the need to use non-Abbott authorised third party apps).

Apparently, Abbott should be communicating this to Libre 2 users over coming weeks.

Hi

The above is true I have Libre 2 sensor and it does take reading every minute which is a big improvement. The only downside is that is does not log the reading for you. You still have to scan to have it logged in your log book in the app.

 

[pcarl]

Is there anybody here who receives a CGM on prescription but is not T1? I am currently free trialing the Libre2 and love it. I m MODY, so don't expect I'll be given a CGM on prescription.

I get my Libre 2 on prescription. I get 4 boxes a months. I'm type 2

 

[pcarl]

Hi can anyone give me any info regarding CGM’s (although I admit I’m assuming these are the monitors you wear as opposed to the finger prick monitors). I am quite new to all of this initially diagnosed as T1 due to my HBA1C reading being 144 which I now have down to 54 and 4 rounds of blood tests showing no T1 indicators. They have now diagnosed me as T2 but I am still on insulin along with metformin. I am really bad for not eating much throughout the day as I have been used to eating 1 meal a day for so long it’s become habit and is hard to break although I know I need to. Because of that I am also not very good at remembering to check my blood sugars. Is there anyway a T2 is able to receive a CGM on prescription? Or are they for T1 only?

Hi

Type 2 can get Libre 2 or Dexcom. I get the Libre 2 on prescription. You can set reminders on it.

 

[jaywak]

Just curious pcarl as to why you are prescribed 4 boxes a month when they last 14 days each .

 

[becca59]

Hi

The above is true I have Libre 2 sensor and it does take reading every minute which is a big improvement. The only downside is that is does not log the reading for you. You still have to scan to have it logged in your log book in the app.

As long as I can see the graph the logbook reading is not needed.

 

[barrym]

Hi

The above is true I have Libre 2 sensor and it does take reading every minute which is a big improvement. The only downside is that is does not log the reading for you. You still have to scan to have it logged in your log book in the app.

My understanding is slightly different, but may be wrong!

There are readings taken every minute. These are now displayed. The system has always taken 15 minutes worth and created a 'smoothed' value. These 15 minute values are sent to LibreView. This can be checked by downloading the data from LV.

The 1 mute values are displayed on the screen, but only while the BT connection is good. If you have a signal loss there will be a gap. The suggestion is that if you do a scan within the 8 hour buffer on the sensor, it will fill the gap.

I might test this theory by not scanning for over 8 hours and see if a gap occurs on LV.

Any thoughts?

 

[clarejenkins]

As long as I can see the graph the logbook reading is not needed.

The log book is needed if you want to add a note. But no great hassle to do the reading

 

[clarejenkins]

Yes you will get. The occasional gap if you are out of range too long and forget to do the occasional scan. But not usually a big problem