DALLAS—Patients who receive continuous glucose monitors (CGM) through durable medical equipment providers have significant advantages compared to those who receive CGM through pharmacy channels, according to newly published research.
The study, “Impact of Continuous Glucose Monitoring Sourcing on Real-World Adherence and Healthcare Costs: A Comparative Analysis by Insurance Type,” was published by CCS, a provider of clinical solutions and home-delivered medical supplies for people living with chronic conditions. The company said the research demonstrates that efforts to expand access to CGMs by adding the pharmacy as a new channel for distribution alongside the established durable medical equipment (DME) provider channel may be having the opposite intended impact, resulting in lower adherence and higher total costs of care.
“Higher adherence rates with continuous glucose monitors are directly linked to improved glycemic control, reduced complications, and lower healthcare costs," said co-author Steven Edelman, a professor of medicine at the University of California San Diego. "This latest research emphasizes the need for industry-wide support of evidence-based decisions that optimize patient access to diabetes technology and improve clinical outcomes.”
Previous studies have shown higher adherence and lower costs with DME providers, but differences between commercial and Medicare Advantage insurance populations have not previously been examined. The findings also emphasize that what has historically been viewed as a simple channel decision related to the distribution of medical supplies to patients significantly impacts outcomes and overall healthcare expenditures.
Notable findings from this latest research include:
- Improved Adherence: Patients receiving supplies through the DME channel demonstrated they were more likely to stay on doctor-prescribed therapy. By 12 months, Medicare/Medicare Advantage patients had a 78% adherence with DME vs. 64% with pharmacy. Commercially insured patients had a 60% adherence with DME vs. 48% with pharmacy.
- Lower Total Costs of Care: Among Medicare and Medicare Advantage patients, total costs of care were 35% lower for those using DME providers. At 12 months, patients leveraging the DME channel cost approximately $3,875 less than pharmacy users ($11,154 vs. $15,029).
- Reduced Healthcare Utilization: Commercially insured patients using the DME channel had significantly fewer emergency room and inpatient days than those utilizing the pharmacy channel (8 days vs. 11 days).
“The data shows patients utilizing DME providers experience higher adherence rates, reduced healthcare costs and fewer emergency interventions compared to pharmacy channels,” said Dr. Arti Masturzo, chief medical officer at CCS. “By focusing on these evidence-based results, we can work toward building a healthcare system where patients receive better diabetes management support while reducing costs for the entire system.”