Recent advancements in medical technology have revolutionized the way we diagnose and treat people with diabetes, making it possible for patients to live longer, healthier lives. Diabetes was once thought to limit an individual’s activities, but medical technology has helped countless people better control and manage the disease.
Diabetes has reached epidemic proportions – with prevalence nearly doubling in the past two decades, rivaling the growth of obesity in America – and is one of the nation’s costliest chronic diseases. In 2012, the disease and related complications accounted for $245 billion in economic costs alone, including $176 billion in direct medical costs and $69 billion in reduced productivity. Alarmingly, these costs represent a 41 percent increase over just five years, from 2007 to 2012, and on average people with diabetes have medical expenditures that are 2.3 times higher than those without diabetes. Complications associated with the disease are often driving these costs, as people with diabetes are more likely to suffer from heart and kidney disease, and to face vision loss and limb amputation.
Though the economics are troubling, the medical technology industry is finding ways to bend this curve in the right direction. Recent innovations are giving patients more control over their glucose levels and are pivotal in driving down the high costs associated with diabetes. Studies have shown that improvements in blood glucose management can reduce a patients’ risk of eye disease by 76 percent, kidney disease by 54 percent and heart attacks by 40 percent. Further, treatment of patients with controlled diabetes can cost two to eight times less than patients with uncontrolled diabetes. This suggests that improved management helps avoid costly complications, saving health care dollars and improving the quality of life for millions of patients.
Among the more recent advancements in diabetes management are insulin pumps, which work by imitating the insulin secretion patterns from the pancreas of a person without diabetes. An estimated 200,000 people use insulin pumps in the U.S., which translates to over $114 million saved each year simply from using a more effective and efficient technology. For patients who inject insulin, advancements in needle technology—including shorter needles with a ﬁner gauge—reduce pain and provide greater ease and convenience.
At a time when we should be doing all we can to get these technologies into the hands of people with diabetes, Medicare’s Competitive Bidding Program is doing the exact opposite and has been found to lead to compromised beneficiary access to the diabetes testing supplies most commonly used by persons with diabetes.
A January 2014 report of the American Association of Diabetes Educators found that as a result of the Competitive Bidding Program, Medicare beneficiaries have fewer choices and limited access to diabetes testing supplies most commonly used. According to the report, beneficiaries are effectively being made to switch to different testing systems that may be unsuitable, unknown, confusing, or unreliable. As a result, testing compliance may diminish or even cease, increasing the risk of complications that can be costly for Medicare.
In addition, recently suppliers were chosen for the Competitive Bidding Program that had no experience providing insulin pumps and related supplies to Medicare beneficiaries. This can also lead to service disruptions and compromised access to medically necessary and covered supplies.
Another advancement that has proven to be effective at helping patients manage their glucose levels is continuous glucose monitors (CGM), a diagnostic technology that allows patients to test glucose levels on a continuous basis, as opposed to just three or four times a day, and without a blood draw. Smaller CGM devices and predictive, customizable alerts that offer early warning of high or low glucose levels are increasingly helping to improve accuracy and management of blood glucose levels. Some can also integrate with modern smartphones, collecting data that allows patients to retrospectively see what might cause hypo- and hyperglycemic events. These monitors provide patients with accurate, real-time information at their fingertips – a true milestone for the management of the disease.
Here, too, current policy is not facilitating patient access to this important new technology since Medicare has made a decision that the technology cannot be covered by the program. Consider what would happen to a patient that has lived a long, healthy life without constant worry of high and low glycemic events due to CGM, only to lose access to this life-saving technology at age 65.
The case of Dr. Korey Hood, a Type I diabetes patient and PhD Associate Clinical Professor of Pediatrics at the University of California, San Francisco, provides a good example of the value that medical technology provides. Korey will run his first marathon this year with the strength, endurance and physical conditioning that his consistent diabetes management helped make possible – with the help of a continuous glucose monitor and insulin pump. People like Korey serve as an inspiration to the diabetes community: His story illustrates how technology has allowed people to continue to thrive while living with a disease that demands constant attention and management.
The future looks even more promising for people with diabetes, and significant progress has been made towards developing a fully functioning artificial pancreas – an innovation that could essentially cure diabetes by connecting CGM and insulin pump technology. Once fully utilized in patients, the potential savings from this device to Medicare alone could reach $1.9 billion over 25 years.
Advancements in medical technology for the treatment of diabetes have come very far, but until we develop a cure, we cannot afford to lose ground against this disease. Industry leaders and policymakers must work together to ensure the right public policies are enacted to support continued investment, innovation and patient access.
|Stephen J. Ubl is the president and CEO of the Advanced Medical Technology Association (AdvaMed).|