Pricey

Confession time here: I am borderline innumerate. Meaning even though I made it through high school calculus with a (barely) B-, I am very bad with numbers. Which is very bad for diabetes management. But that’s a whole other story.

What I’m getting at today is that I hadn’t actually done the math on my beloved new continuous glucose monitor (CGM) until now, and attempting to add up my costs thus far, I do not like what ISmash_the_piggy_bank_1 see. Not even counting the initial investment in the CGM unit itself:

- Three 5-packs of sensors at $175 each ($35 per sensor) = $525

- Three 100-count vials of test strips for the OneTouch meter (necessary for using the DexCom), purchased on eBay for an average of .57 cents each = $171

- Seven 10-packs packs of DexCom shower patches (yeah, using about 2/day in this heat) at $17 each including S&H = $119

Now if I’m not all stupid, that’s $815 in supplies just since the end of June.

No, I have not used up all those sensors yet! And yes, I know that you can wear them longer than 3 days. I haven’t managed to wear one longer than 2 rounds (6 days), however, since all the sun and sand has made the adhesive peel off to the point of no return.

Anyway, lots of DexCom mentions on my credit card bill. And no answer yet from Blue Shield, where I submitted a claim along with my Letter of Medical Necessity some 10 days ago. Just a blink of the eye for an HMO. Probably will be another 8 weeks before I even hear from them.

My telephone inquiry was acknowledged with the pat answer that I am covered for “diabetes testing supplies” — but this tells me nothing, since the DexCom will likely be viewed as something akin to űber-testing-supplies: fancy extras that overlap with the traditional and less costly stuff my insurance is already paying for. In other words, I doubt they’re going to accept the claim.

I was surprised to see that Anna Q over at Life with a Spouse believes they are saving money by using the Dex. It seems it’s the test strips making the difference. Her husband Jack was using 14 strips/day at .90 cents each before, and only about 2/day now. I’m definitely using more, since my Dex seems HUNGRY for calibration numbers, and after a few initial missteps, I’m careful about checking with a fingerstick before making any dosing moves.

So here’s my problem: having just done battle with my insurance, prior to making the leap to CGM, in order to obtain abundant supplies of FreeStyle test strips, I am now up the creek without a strip source, so to speak. Suddenly I need quantities of the LifeScan strips instead, and I’m 100% sure the insurance won’t go for that. Not now, anyway.

Glancing down just now at another 107 reading on the CGM. Oh joy! And trying not to think where else the $815 might have gone.

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15 Responses

  1. Val
    Val July 27, 2006 at 8:11 am | | Reply

    Skip the shower patches except for trips to the beach. I asked DexCom, and they said getting the transmitter wet in the shower will not harm it, but may make the readings off until it dries out. I have seldom noticed this being an issue, and when it is off it’s for less than an hour. Good luck with insurance — haven’t heard from mine yet either.

  2. Judy
    Judy July 27, 2006 at 9:22 am | | Reply

    Isn’t it amazing what lengths insurance companys will go to NOT to pay a claim!!? And then when a needed item is not available, the disease progresses to a much more expensive hospital stay! I’ve always wondered what moron is charge that can’t see that an ounce of prevention is better than the expensive hospital stay!!

  3. Bruce
    Bruce July 27, 2006 at 9:50 am | | Reply

    At first fiscal blush $815 seems like a lot of money, BUT if this investment (even if it’s not reimbursed from your medical provider) provides you with a healthier state of mind (and hopefully more accurate knowledge) about what’s going on for your BG, then I expect it will be positive & quite cost-effective for you. Of course, we live in a monetary universe, and $815 is no small amount of change. My guess is that eventually the medical reimbursement community will provide support for these expenses (emphasis on “eventually”). For some time, Kaiser will provide continuous BG monitors on a temporary basis (e.g., 3-4 days) to us Ds, sort of as a complement to the now normal at-home BG monitors. Every advance in D care seems to be more expensive than before, and the costs are, in the beginning, borne by first-users. For an interesting view of one aspect of this process, check out BusinessWeek’s May 29 cover story “Medical Guesswork” [ http://www.businessweek.com/magazine/content/06_22/b3986001.htm?chan=search ]. So, my hat’s off to you and other first-users. Keep the real story coming in, so we can learn more about this (and other) developments.

  4. art-sweet
    art-sweet July 27, 2006 at 11:04 am | | Reply

    hmmm, I think I have lots of onetouch strips left over. send me an email.

  5. Alexis
    Alexis July 27, 2006 at 11:54 am | | Reply

    Amy are you having trouble with getting testing strips because you use the mail order system from your health care plan? My experience with those have been somewhat negative since I’ve run into the same problem as you where they will only send them to you after a determined amount of time. In my case it was 3 months, so I had my doctor write me super large quanitites for 3 months and then battled with the insurance company down from that.

    Better way to do it IMHO, is to use walgreens mail service. Its super cheap for deliveries and they send you your insulin with a freezing pack which you can reuse. I always pick regular shipping but I think when they send me insulin they send it express or priority.

  6. AmyT
    AmyT July 27, 2006 at 2:31 pm | | Reply

    It’s not the mail order itself, but the fact that my insurance recently OK’d large quantities of one type of test strip and now I need another. *sigh*

  7. JasonJayhawk
    JasonJayhawk July 27, 2006 at 7:13 pm | | Reply

    Amy, if you had to choose between an insulin pump or the CGMS, which would you keep? I wish insurance would allow us to make that decision — personally, I’d pick the CGMS. I think the CGMS costs more than a pump, though, unless you factor in cost savings from not having to buy as many strips!

    Hmmmm… Would you pay us $119 to make you home-made shower patches out of garbage bags and duct tape? Let us know, and I’ll go get some scissors and some Quackeriffic-brand Duck Duct tape!

  8. Lori
    Lori July 28, 2006 at 6:49 am | | Reply

    Hi,
    I just started on the Dexcom yesterday. I am on a one week free trial before I decide if I want to buy it. So far so good. Thanks so much for your blog. My husband and I were able to get an idea of what it may be like before I even got on it.

    Anyway, I saw in your post that you are having trouble getting the tape to stick. I had this trouble with my pump a while ago when I lived in AZ. I bought a product called Mastisol Liquid Adhesive from MiniMed and it worked great. You also need to by Detachol Adhesive Remover to get the extra adhesive off. I don’t think it cost a lot but it has lasted forever. It may be worth a try.

  9. been there
    been there July 29, 2006 at 12:43 pm | | Reply

    Amy – I don’t think I’d be that distressed over the insurance company. I’d just take the approach that you need a larger quantity of a different kind of strip. You are concerned about qty, no? Well you already scaled that hurdle, now you’re just changing brand. That happens all the time. The quantity required is the harder part. Also, when you talk to the rep at the ins co just be matter of fact that the qty is the qty, and be as frustrated as you know she/he is that you have to make yet another change :)

  10. JediSkipdogg
    JediSkipdogg July 30, 2006 at 4:24 am | | Reply

    Keep in mind that it took insurance companies many years to pay for insulin pumps. These aren’t cheap items. You may say in the long run it will save them money, but right now most insurance companies already lose money on diabetics. I know I do. My work pays my insurance premiums 100%, lucky me, and that is around $7200 a year. I calculated my supply usage once for a year and I use close to $9000 in medical visits and supplies a year. My insurance is LOSING money on me, and most people don’t have $600 a month premiums.

    You also have to keep in mind, these devices are being marketted as supplements to fingersticks. So while you think only 2 fingersticks a day is needed, you really are suppose to do more, and insurance companies see that and see they aren’t saving much money.

    Lastly, you have the accuracy of the devices. Google Minimed CGMS Accuracy and Dexcom Accuracy and you’ll be amazed at some of the charts you see. The devices are good, but not ready for full blown use.

    Another key part in price that wasn’t mentioned in the original article. For Dexcom, the transmitter has to be replaced every 6-12 months because of battery life, and that’s a $250 replacement. Then the receiver has to be replaced every 12-18 months for the same reason, and that costs $500. So now the insurance has an additional $1000 each year to replace for the basic devices just because a $2 battery can’t be user replaced.

  11. Becky
    Becky July 30, 2006 at 5:54 am | | Reply

    Jedi,
    This may be true but people are winning coverage on appeal. See July 22 at http://www.untilacure.blogspot.com/
    I’m in disagreement with, well, probably everyone on this LOL! I think insurance is going to cover these things sooner than expected. Continuous real time data can save them money on expensive glycemic excursions that send people to emergency rooms and hospitals, not to mention EMS calls for severe hypos. Hasn’t been clinically proven yet,I know, but I bet the number crunchers will figure it out soon.

    Sorry about the test strip dilemma Amy. Hopefully they won’t give you a hard time about switching brands!

  12. John
    John August 2, 2006 at 6:05 am | | Reply

    Personally, I’m waiting for FreeStyle Navigator. I hear the price will be somewhat lower, but Abbott may help push along the development of medical policies that will help users. Only time will tell.

  13. don a
    don a August 5, 2006 at 8:56 am | | Reply

    walgreen’s strip only cost $.50 each
    with their meter.I was looking for a new meter and person behind the counter told me it’s the cheapest.

  14. MikeG
    MikeG August 14, 2006 at 1:24 pm | | Reply

    Amy,

    I think you can cut down on that bill somewhat. I only use the shower patches for swimming. For showers, I’ve found that a sheet of Glad Press and Seal (basically, sticky saran wrap) works well enough. The sensors can take a good bit of water, so if some gets through, you’ll still be ok. I actually had a shower patch open up when I was swimming laps once. Despite being completely underwater for 10 minutes, the sensor came back to life after I towelled off and sat in the sun for a few minutes.

    I’m another one of those who’s gone from needing 10 strips a day to 3-4. If you’d like, I can send you some OneTouch strips.

    For me, the cost of my Dex is going to be about $2000 a year (I’m getting 7-10 days per sensor, despite running and biking in 100 degree heat, and my OneTouch strips are paid for by insurance.) If I were paying full price for either 10 strips a day, or 3-4 per day plus Dex, I think I’d break even.

    The real punch line for me is this: my A1C has gone from 7.5 – 8.0 to 6.5, my energy’s up, and I can do things I could never do before.

  15. Rick Stockton
    Rick Stockton October 13, 2006 at 2:01 pm | | Reply

    MikeG and others have great advice– just use Saran wrap, and waterproof gauze tape on at least 3 sides (top and two sides, leave the bottom open saves a few inches of tape.

    And ABSOLUTELY try JaysonJ’s suggestion: better adhesive! I live in low humidity (Reno NV= high desert), so my Sensor adhesive pads don’t get ratty until way after a week. (Trouble, if it happens at all, happens during days 12-20.) I just use gauze tape to tape down the ratty edges. But high-quality adhesive would be much more effective, TRY IT!

    When you leave the Sensors on for a long time, you might start to react to the adhesive. an ‘IV Prep’ liquid might also be helpful.

    Are you using good Sensor locations, or just whacking your belly (to close to insulin infusion sites)? Their instructions that you can be just an inch away from visible old infusion site scars, and even right on top of invisible ones, were BAD for me. I never got more than 5 days until I switched to my sides, and they were failing even before 3 days until I moved. Now I average 17-18, very consistently. (Personal record is 20.)

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