@scorpius14 - I've put some thought into this in the past and the real answer is that it's extremely difficult to do. One idea was a "personal glucose testing budget", where you have two options.
- Continue as now
- You receive 80% of the total cash required for fingerstick testing 8x per day (£1095) as a budget, which you can use on whatever monitoring you like.
The issue of course with the latter is "What happens when you run out of budget?". If you consider that 80% of the cost of testing 10x per day is a little less than full coverage of Libre on the NHS and less than half of the coverage of Dexcom G6 on public subscription, you can see a place where a lot of people exhaust their budget half way through the year and instead of sensibly putting aside what they are required to pay personally, simply use the remaining 20% on "free test strips" and test far less frequently than they need.
There are of course two stipulations on this:
- Something like 1/3 of UK T1Ds test far less than once per day, so the spend vs budget for T1Ds gets blown out of all proportion.
- The cost of administration of scheme like this is likely to be relatively high compared to the model we have no, a cost that I'm not sure the NHS would want to burden itself with.
Once you start looking at something like this, where there is a co-pay, it also opens up the spectre of a US insurance based model via the back-door, rather than the mutualized insurance models prevalent across Europe.