Pump cost comparison for private funding

[GrantGam]

Grant, have you checked the Input website? NICE are not the only guidelines. There's also the ABCD stuff on which far more people qualify. There's more here: http://www.inputdiabetes.org.uk/alt-insulin-pumps/is-it-provided-by-the-nhs/

ABCD recommends that insulin pump therapy is also considered in the following situations:
• Pregnancy
• Acute painful neuropathy or symptomatic autonomic neuropathy if
conventional treatment fails to enable adequate blood glucose control
• Hypoglycaemia unawareness
• Extreme insulin sensitivity
• Needle phobia
• Severe insulin resistance with poor blood glucose control
(especially if type 2)
• Specific quality of life issues:
– Pathological fear of hypoglycaemia
– Marked glycaemic excursions/dawn phenomenon
– Excessive number of injections for optimised control
– Impaired exercise capacity, abnormal eating behaviour or an unacceptable number of sick days
– Shift work or frequent travel across time zones
– In children: sub-optimal school performance, exclusion from aspects of a full school life; behavioural problems (for example, mealtimes); adverse impact on family dynamics

Mine was obtained on the grounds of marked glycaemic excursions/dawn phenomenon, with Glycaemic Variabilty stated as the cause, along with excessive number of injections.

Yeah I'd definitely qualify for the excess of injections for good control and DP messing up that good control. That's for sure.

Thanks for providing that extra insight!

Grant

 

[tim2000s]

Then you can get going with a pump (and also low carb, but decent amounts of protein) and get traces that do this!

Sent from my iPhone using Tapatalk

 

[GrantGam]

@tim2000s, have you any idea of the costs for the Medtronic Paradigm Veo?

 

[tim2000s]

@tim2000s, have you any idea of the costs for the Medtronic Paradigm Veo?

Which model?

 

[GrantGam]

Which model?

I'd imagine the latest in the 5 series, it has the smaller reservoir?

I had a phone call with a Dr from my diabetic clinic yesterday, and we went over some aspects of pumps, etc. She said they normally issue the Paradigm Veo to adults. I never got an exact model number so I can't be certain, but I'd hazard a guess at the newest 5 series.

The reason I ask, is that an Animas pump (possible the Vibe model) is also offered, although typically allocated for pediatric use. Although the aim is to ultimately obtain NHS funding, knowing the private funding cost differences between the two would be handy should I be leaning towards a specific pump. The costs between NHS and private may be different, but at least I'd have a rough idea if one was significantly pricier than the other.

FYI, currently waiting on a response from Medtronic but just thought I'd see if you were aware

Cheers.

 

[tim2000s]

I've never asked about the Veos. To be honest, I don't know if the NHS is offering them any more? THey certainly don't in our area. I imagine you'll be quoted similar to the 640G by Medtronic. Used ones can be bought online for anywhere between about £300 and £800. Current market value is on average about £600.

 

[GrantGam]

I've never asked about the Veos. To be honest, I don't know if the NHS is offering them any more? THey certainly don't in our area. I imagine you'll be quoted similar to the 640G by Medtronic. Used ones can be bought online for anywhere between about £300 and £800. Current market value is on average about £600.

I guess I won't know for sure until I meet with the Dr in charge of pump therapy for my region. According to IPAG, it seems as though the Veo is still offered. Whether they are now superceded by the 640G, I'll just have to wait to find out. For now I can assume the consumables cost for the Veo will be there or there abouts the same as the 640G?

http://www.ipag.co.uk/pumps-available-in-scotland/

Thanks again.

 

[tim2000s]

I guess I won't know for sure until I meet with the Dr in charge of pump therapy for my region. According to IPAG, it seems as though the Veo is still offered. Whether they are now superceded by the 640G, I'll just have to wait to find out. For now I can assume the consumables cost for the Veo will be there or there abouts the same as the 640G?

http://www.ipag.co.uk/pumps-available-in-scotland/

Thanks again.

They use the same consumables, so it will make no difference. If you go with a 1.8ml reservoir, it will cost more because the 3ml and 1.8ml reservoirs are the same price and I have no issues with using them for a week (which is safe and was proven in research years ago using the exact same reservoirs).

The Veo 554 is about 1cm smaller in length than the 754, but I'm not sure why you'd opt for one of those, given Smartguard in the 640G?

 

[GrantGam]

If you go with a 1.8ml reservoir, it will cost more because the 3ml and 1.8ml reservoirs are the same price

Is that a typo or am I missing something?

I genuinely don't even know if the 640G is offered in my region though. So it's not a case of dismissing the 640G. I was told that the Veo is the pump of choice for adults where I live.

I'm pretty sure the Veo is compatible with enlite sensors and supports smart guard?

 

[tim2000s]

Is that a typo or am I missing something?

I genuinely don't even know if the 640G is offered in my region though. So it's not a case of dismissing the 640G. I was told that the Veo is the pump of choice for adults where I live.

I'm pretty sure the Veo is compatible with enlite sensors and supports smart guard?

For me, because I can get 6.5 days out of the 3ml reservoir, I use them at half the speed I use the 1.8s. As a result I use fewer of them. I ignore the guidance (from Medtronic) to replace the reservoir every three days as independent research has been done that proved that Novorapid remained stable in a pump reservoir safely for 10 days.

I therefore use fewer 3ml reservoirs, which cost the same as 1.8ml reservoirs, as I would 1.8ml reservoirs.

The "Smartguard" on the Veo is only "Suspend on low". On the 640G it's predictive so it suspends before you go low, and due to the algorithm it uses, it's pretty good with limiting lows across the board. It means you can be more aggressive on your meal boluses pretty safely. I wrote something about it here: http://www.diabettech.com/artificia...d-smartguard-into-the-glastonbury-2016-wilds/

 

[GrantGam]

For me, because I can get 6.5 days out of the 3ml reservoir, I use them at half the speed I use the 1.8s. As a result I use fewer of them. I ignore the guidance (from Medtronic) to replace the reservoir every three days as independent research has been done that proved that Novorapid remained stable in a pump reservoir safely for 10 days.

I therefore use fewer 3ml reservoirs, which cost the same as 1.8ml reservoirs, as I would 1.8ml reservoirs.

The "Smartguard" on the Veo is only "Suspend on low". On the 640G it's predictive so it suspends before you go low, and due to the algorithm it uses, it's pretty good with limiting lows across the board. It means you can be more aggressive on your meal boluses pretty safely. I wrote something about it here: http://www.diabettech.com/artificia...d-smartguard-into-the-glastonbury-2016-wilds/

Ah I see what you mean, thanks for clearing that up for me

That's pretty clever suspending before going low, it's a shame the Enlite sensors are fairly pricey.

Will be waiting patiently for my appointment with the regional director (I think that's his title); to see where we go next on this pump journey. Won't get my hopes up too much, but it's still exciting all the same.

Thanks for the input, @tim2000s.

 

[asa35]

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.

@tim2000s , this is very useful information, thanks for your research. I realise this was last year, but as I'm trying to decide on a pump (my first one, so very confused with everything at the moment!!!), this is good for me. My pump will be funded through the NHS and I've narrowed my choices down to the Animas Vibe and the Medtronic 640G. I'm leaning a bit more towards the 640G because I prefer the layout better and the menus are easier to navigate (the Vibe layout does appear more old fashioned in the layout). My only issue is for the CGM costs: currently, Animas offer the Dexcom G4 starter pack @ £250.00 with replacement sensors @ £50.00 ea or £186 per 4 (not sure if they charge c&p). I can't seem to get an answer from Medtronic at the moment for their CGM costs, but from your details above, what are Monthly Consumables????
Any help with this would be appreciated as I seem to be going around in circles at the moment and I need to make a decision asap for which pump I want.
I do also currently use a Libre, and a possible option is to stick with this and manually enter data to the pump.
Many thanks

 

[misspinky1984]

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

Hello I hope you don’t mind me messaging you how long did you wait to get funding after your consultant requested a pump for you ? I’ve been waiting 8 weeks and I was told about 4-6 weeks thanks

 

[Angusc]

7 years from requesting the pump mainly due to the need for the cgm

 

[tim2000s]

Hello I hope you don’t mind me messaging you how long did you wait to get funding after your consultant requested a pump for you ? I’ve been waiting 8 weeks and I was told about 4-6 weeks thanks

Hi @misspinky1984 . My process was that I demanded that the Specialist Registrar request that i go on a pump from the senior consultant in January. I received a letter two weeks later inviting me to a pump clinic two months later. I went to the pump clinic and refused to leave until I'd seen the DSN, Consultant, Dietitian and Psychologist on the same day (they tried to fob me off with multiple days of appointments, so I took the slack up in their schedule). I then batted the DSN into submission to do a 1-to-1 pump start with me because I couldn't make the group dates and I was adamant that I didn't need to spend a day learning how the pump worked as I'd read the manual. All in all, I went from the clinic in January to receiving my pump in early May.

There was never any discussion about funding as Guys operates on the basis that the money is there to be used. You just have to be a bit obstreperous to get it.

 

[himtoo]

Hello I hope you don’t mind me messaging you how long did you wait to get funding after your consultant requested a pump for you ? I’ve been waiting 8 weeks and I was told about 4-6 weeks thanks

hi there
from initial appointment to put me forward for a pump to the day i started pumping was 13 months ............but i know a bloke in my same catchment area that has progressed through the same hurdles in about 7 months.. he is due to start in about 3 weeks

 

[misspinky1984]

Hi @misspinky1984 . My process was that I demanded that the Specialist Registrar request that i go on a pump from the senior consultant in January. I received a letter two weeks later inviting me to a pump clinic two months later. I went to the pump clinic and refused to leave until I'd seen the DSN, Consultant, Dietitian and Psychologist on the same day (they tried to fob me off with multiple days of appointments, so I took the slack up in their schedule). I then batted the DSN into submission to do a 1-to-1 pump start with me because I couldn't make the group dates and I was adamant that I didn't need to spend a day learning how the pump worked as I'd read the manual. All in all, I went from the clinic in January to receiving my pump in early May.

There was never any discussion about funding as Guys operates on the basis that the money is there to be used. You just have to be a bit obstreperous to get it.

Hello I've been given the funding finally and been given the choice of the Medtronic or Accu-chek insight x the pump I wanted is not in the uk yet

 

[Irene Banting]

I agree with so many of the comments here. In Australia the majority of people have private health insurance, and pumps are covered every 4 years, when the warranty runs out. So I have in my drawer 4 used but functioning pumps. We used to be able to pass them on to a clinic or to an individual person. Also people used to sell them on EBay. Now due to new guidelines and fear of litigation etc etc, you can't do either. What a criminal waste!
I am not sure but I think here, at least, you can get around this by giving your pump away, and that person can take it to a clinic and sign a waiver of some sort so they can access pump education and the subsidised consumables. I have offered my latest used one to my friend and to my nephew, and neither of them want a pump as they prefer MDI.
Does anyone know if someone in the UK could access the consumables on the NHS if their pump was given to them privately?

 

[Juicyj]

Hello @Irene Banting Just to note this thread is 19 weeks old, as a tip when thinking about responding to old threads it might be worthwhile starting a new thread

The NHS doesn't sell consumables to private consumers, if someone were to purchase their own pump then they would need to contact the pump manufacturer direct for consumables.

 

[Irene Banting]

Oh, thanks. I am not used to forums. Not even on Facebook but I'll get there