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Libre on NHS, what's happening about Dexcom
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<blockquote data-quote="tim2000s" data-source="post: 1561443" data-attributes="member: 30007"><p>[USER=137512]@MoonSpirit[/USER] - there is already guidance within the NICE guidelines for Dexcom, and if you are someone for whom Dexcom is truly lifesaving, then that's what should be used to make a case for it via your clinic and GP. As it stands at the moment, the cost model for Dexcom (based on sensor changes every 7 days, which is what they must base it on) doesn't stack up in the NHS QALYS method for all users. It works out at around £3,400 per year, vs £960 for the Libre. </p><p></p><p>In context, a Hypo call out for an ambulance is around £250 and one night's stay in a hospital about £700 so calling an ambulance is more cost effective than Dexcom unless you do it more than 12 times a year. It's a horrible way of looking at it, but unfortunately it's the kind of equation the NHS and CCGs use. </p><p></p><p>The key thing to do is think laterally. Given that CCGs currently approve "one sensor a month" for certain patients wanting CGM (usually kids), there is precedent. Once the Libre is available and provided by the CCGs, there's nothing to stop us putting together a case that instead of Libre, we'd like Dexcom or Enlite sensors. Using the £35 cost to the NHS of Libre annually, it should be possible to argue the case for support in Dexcom, which works out to 16 sensors a year. </p><p></p><p>Now the CCG can only condone that use in a similar way to the "one a month model" I mentioned earlier, but if you extend the Dexcom sensors as most do, then you can start to recover some of the costs. Once people start doing that, it's an easier step to move reimbursement for Dexcom or Enlite onto the Drug Tariff. </p><p></p><p>In addition, the next gen Dex sensors are supposed to be cheaper and last for two weeks, so if they can be provided at parity with Libre or better, that would open the door to getting them on prescription. They aren't due till late 2018 though.</p></blockquote><p></p>
[QUOTE="tim2000s, post: 1561443, member: 30007"] [USER=137512]@MoonSpirit[/USER] - there is already guidance within the NICE guidelines for Dexcom, and if you are someone for whom Dexcom is truly lifesaving, then that's what should be used to make a case for it via your clinic and GP. As it stands at the moment, the cost model for Dexcom (based on sensor changes every 7 days, which is what they must base it on) doesn't stack up in the NHS QALYS method for all users. It works out at around £3,400 per year, vs £960 for the Libre. In context, a Hypo call out for an ambulance is around £250 and one night's stay in a hospital about £700 so calling an ambulance is more cost effective than Dexcom unless you do it more than 12 times a year. It's a horrible way of looking at it, but unfortunately it's the kind of equation the NHS and CCGs use. The key thing to do is think laterally. Given that CCGs currently approve "one sensor a month" for certain patients wanting CGM (usually kids), there is precedent. Once the Libre is available and provided by the CCGs, there's nothing to stop us putting together a case that instead of Libre, we'd like Dexcom or Enlite sensors. Using the £35 cost to the NHS of Libre annually, it should be possible to argue the case for support in Dexcom, which works out to 16 sensors a year. Now the CCG can only condone that use in a similar way to the "one a month model" I mentioned earlier, but if you extend the Dexcom sensors as most do, then you can start to recover some of the costs. Once people start doing that, it's an easier step to move reimbursement for Dexcom or Enlite onto the Drug Tariff. In addition, the next gen Dex sensors are supposed to be cheaper and last for two weeks, so if they can be provided at parity with Libre or better, that would open the door to getting them on prescription. They aren't due till late 2018 though. [/QUOTE]
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