Pump cost comparison for private funding

tim2000s

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Given some of the shenanigans and hoops required to obtain CCG funding for pumps, I thought I'd reach out to the pump companies and ask how much it would cost to purchase their various wares via private funding instead of CCG funding. The results are interesting, but not massively surprising, if you have read the NICE CSII tech appraisal.

Each pump can be split out into a one off cost for hardware and then monthly or quarterly costs for consumables. These tend to vary a little by person, so I have the modal values for plugging into a model. The details show the cost of the one-off investment, the monthly or quarterly cost, which will be specified and the annual consumable charge. I contacted Ypsomed, Roche, Medtronic and Animas. All prices are ex. VAT.

Roche - Accuchek Insight

Pump Kit + Meter: £2,495
Quarterly Consumables: £370
Annual Consumables Cost:£1,480

Total First Year Cost: £3,975

Medtronic - Minimed 640G

Pump kit: £2995
Monthly Consumables: £97.90
Annual Consumables Cost:£1,174.80

Total First Year Cost: £4,169.80

Note that Enlite CGM Sensors can also be purchased at a cost of £525 for 10 or £275 for 5.

Ypsomed - Omnipod

PDM Handset: £420
Monthly Consumables: £251.50
Annual Consumables Cost:£3,018

Total First Year Cost: £3,438

Note that it would be possible to replace the PDM by buying yourself a new one when the new, Dexcom integrated version becomes available some time in 2016.

Animas - Vibe

Pump Kit: £2,800
Monthly Consumables: £137
Annual Consumables Cost: £1,647.95

Total First Year Cost: £4,447.95

As can be seen from the numbers, there is a significant difference in cost between the least and most expensive options available. This should also provide help for people who are looking to find out the value of a pump for insurance purposes.
 

CarbsRok

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You still have to have approval from a GP or consultant to self fund though.
How were the consumables worked out, are all the cannula types the same price?
Have a look at the DanaR pump, that works out cheaper than them all I think.
 

tim2000s

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The consumables were worked out based on the modal, i.e. the most frequently bought combinations @CarbsRok.

You are correct, you need HCP approval to self fund, but I thought it was worth bringing the costs out into the open. On the consumables front, I'd suggest that the costs are taken with a +/-15% tolerance as they are bound to vary. I'll add in the DanaR as it wasn't one I was aware of.
 
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CarbsRok

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@tim2000s Advanced Therapeutics sell the DanaR :)
Some consumables are a lot more pricey than others so well worth looking into that if self funding :) I soon learnt this when I self funded many years ago.
 

tim2000s

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An update from AT on the DANA Diabecare R pump. It is not possible to privately fund one of these, similar to the CellNovo. Having said that, having a theoretical discussion about cost of acquisition, the Dana is sub-£2,000 to acquire and the consumables will be in the ball park of the other tubed pumps.
 
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himtoo

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why can't everyone get on........
Hi tim2000s
as is always the case with your posts -- well researched and informative.

Omnipod is the pump I am hoping to get a bit later this year --appointment with consultant is in 2 weeks.
dietician and DSN approval already secured
 

CarbsRok

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An update from AT on the DANA Diabecare R pump. It is not possible to privately fund one of these, similar to the CellNovo. Having said that, having a theoretical discussion about cost of acquisition, the Dana is sub-£2,000 to acquire and the consumables will be in the ball park of the other tubed pumps.
You can privately fund but have to be under the care of a consultant. AT will only do pump set up with a hospital team. Perhaps there was some confusion with the wording of your research. There's a private London clinic that allows you to purchase the pump and have care under them.
 

tim2000s

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There's a private London clinic that allows you to purchase the pump and have care under them.
As soon as you do that though, you are also paying private healthcare rates + self funding the pump...
 

CarbsRok

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As soon as you do that though, you are also paying private healthcare rates + self funding the pump...
Very true, but AT always did do self funding as long as you had HCP approval. I know as I did this :)
 

tim2000s

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Very true, but AT always did do self funding as long as you had HCP approval. I know as I did this :)
They seem to have changed their plans... The DANA R doesn't look like a bad pump.
 

masonbason63

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You still have to have approval from a GP or consultant to self fund though.
How were the consumables worked out, are all the cannula types the same price?
Have a look at the DanaR pump, that works out cheaper than them all I think.

These are interesting costs made by tim2000s what really grates my chin is that even if you want to go on any pump, you have to have the approval of a consultant or team before you can, I hate being dictated to as to what's good for me or not.
You think that there would be more support,
Also you do when purchasing yourself these brilliant machines enter the realms of private healthcare
 

CarbsRok

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These are interesting costs made by tim2000s what really grates my chin is that even if you want to go on any pump, you have to have the approval of a consultant or team before you can, I hate being dictated to as to what's good for me or not.
You think that there would be more support,
Also you do when purchasing yourself these brilliant machines enter the realms of private healthcare
I had GP approval and my NHS care was exactly the same, didn't find it a problem. :) I also quite agree about the dictating to side of things.
 
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tim2000s

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I had GP approval and my NHS care was exactly the same, didn't find it a problem. :) I also quite agree about the dictating to side of things.
Given my GPs response to Tresiba, I suspect that they'd be very unlikely to provide approval for a pump, even if they didn't have to fund it. Guess I won't find out until I ask though!
 

CarbsRok

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Given my GPs response to Tresiba, I suspect that they'd be very unlikely to provide approval for a pump, even if they didn't have to fund it. Guess I won't find out until I ask though!
My GP has a very practical view point. A pump is an insulin delivery device :)
 

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Thanks for putting this info together, Tim. Added as a sticky, since it could potentially be very useful for people considering funding their own insulin pump!
 
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tim2000s

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My GP has a very practical view point. A pump is an insulin delivery device :)
My view too, and if it was done that way I could use it as I want to... Rather than as I am told to by the clinic who must be oberyed.

Thanks for putting this info together, Tim. Added as a sticky, since it could potentially be very useful for people considering funding their own insulin pump!
Yay - my first sticky :D
 
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Spiker

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Given these costs are a lot higher than the CGM costs you laid out in another post, it is very frustrating CGM is not funded. In my case at least, CGM has a profound improvement on Hba1c and the pump had an adverse effect. In fact iirc NICE's data shows no hba1c benefit from pumps. What are NICE playing at? The health economics of funding pumps but not funding CGM seem totally wrong.

Thanks for building the data for the case Tim.
 
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tim2000s

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Actually, the NICE evidence for pumps (CSII) isn't as bad as you make out @Spiker.

A total of 46 studies reported HbA1c levels before and after CSII therapy. Of these, all 18 studies in the adult/mixed age group showed a statistically significant decrease in HbA1c levels (in the range 0.2–1.4%) after initiation of CSII therapy.

Of the 23 studies in the children/adolescent age group, 20 studies showed a decrease in HbA1c levels after starting CSII therapy (in the range 0.2–1.2%) with the difference reaching statistical significance in 13 studies.

The other aspect of this which is important from a NICE point of view is the reduction in Hypos, and this was also statistically significant.

Twenty-six observational studies compared the rate of severe hypoglycaemic episodes in people receiving CSII and MDI therapy. Of the 10 studies in the adult/mixed age groups, eight reported statistically significant decreases in the rate of severe hypoglycaemic episodes after starting CSII therapy.

Of the 11 studies in children and adolescents, one had no severe hypoglycaemic episodes and the other 10 reported decreases in their frequency following initiation of CSII therapy, with rate ratios in the range 0.12–0.80. In four of these studies, the reduction was statistically significant, three did not report significance, and three did not show a statistically significant decrease.

The clinical specialists emphasised the robustness of the evidence that allowed the decrease in HbA1c levels to be used as a reliable proxy for avoidance of the long‑term complications of diabetes mellitus.

As a result, the evidence gathered here was considered as a strong positive for pump therapy.
 
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