According to the health economic analysis, the reduction in severe hypoglycemic episodes and myocardial infarctions led to cost savings of €24.14 per patient per year. Considering 390,000 type 1 diabetes patients or 2.3 million insulin-treated patients in Germany, these savings could be equal to a reduction in health care expenditures of more than €9.4 million and €55.5 million, respectively.
Potential cost savings and clinical effects due to higher accuracy of BG meters should provide an impetus to implementation of tighter accuracy standards and development of glucose meters that provide highest possible accuracy.
Now, after a successful experiment in nine metropolitan areas, Medicare has instituted competitive bidding for mail-order firms that want to sell strips; it has signed contracts with just 18 carefully vetted companies nationwide. That’s a big shift from the hundreds of suppliers who used to sell strips to Medicare recipients.
The process has cut prices sharply. Medicare previously paid $77.90 for 100 mail-ordered strips; now it will pay $22.47. That means co-payments plummet, too, from $15.58 to $4.49.
Diabetics who must test their blood glucose levels daily, often multiple times a day, could have fewer choices of where to buy testing strips.
The reason? The price drop of 72 percent is too low for some providers to stay in that business, they say.
“We are going to stop serving diabetic patients on Medicare. The pricing is below our cost,” said Joel Marx, chairman of Cleveland-based Medical Service Co. “The diabetic market has just been decimated.”
That doesn’t mean patients will forgo their daily self-testing, considering the presence of large national companies. CMS is offering contracts to 15 national mail-order test strip suppliers, in fact, at the new lower rate. But the needs of every patient are different, and getting the right supplies at the right time might be more challenging, patient advocates say.
“We’re frightened for our patients at this point,” said Martha Rinker, chief advocacy officer for the American Association of Diabetic Educators, whose members work with patients to keep their disease under control.
Accuracy. This is many people’s top concern when choosing a meter. And yet, we don’t report it in this guide. Independent accuracy testing is expensive, complicated, and rare. Diabetes Forecast, for example, doesn’t test or recommend products because the American Diabetes Association is a nonprofit organization without a laboratory or expertise in lab comparisons of products. Where the data do exist, in the form of manufacturers’ tests, accuracy is reported in different ways. Some companies report accuracy as a “regression line,” involving correlation coefficients, slopes, and Y-axes. Others report in a friendlier table format using percentages.
Those measures of accuracy are apples and oranges. “It’s not possible [for a consumer] to do a direct comparison of how accurate one meter is to another,” says Katie Serrano, supervisory biologist and diabetes branch chief at the Food and Drug Administration’s Center for Devices and Radiological Health. “We’ve seen cases where cheaper meters don’t necessarily have all the bells and whistles, but have better accuracy.” She says users have to evaluate all of the features that are important to them.