17 Responses

  1. June S.
    June S. March 11, 2013 at 6:51 am | | Reply

    Wow! This is awful! I am not yet on Medicare, but my parents are, and what is going on now is nightmarish! If any of you diabetesmine folk are so inclined (since, because you have a blog with many followers) may I suggest that one of you contact Sixty Minutes? I think this story deserves to go on TV, before our A1Cs start rising due to inaccurate blood glucose meters!!!!!

  2. kevinlmcmahon
    kevinlmcmahon March 11, 2013 at 9:18 am | | Reply

    My reason for being concerned about this change relates directly to my experience in a Medicaid demonstration pilot. During the enrollment phase, we learned first hand about some of the nasty ‘switching’ practices of DME providers – switching patients to different off brand meters based on kickbacks from manufacturers to increase DME profits.

    The worst part was the complete and total lack of training provided to the patients when they received their new meter. This is a huge issue that should be addressed now. The new meter companies had better be ready to provide patient training although I fear that critical piece has been left of the chess board.

  3. Puddin
    Puddin March 11, 2013 at 10:12 am | | Reply

    I find this info suspicious just on its face. The idea that the margins are too thin as to be profitable is preposterous. Per a Diabetes Forecast article from June 2012, ave cost to manf a strip is 15 cents. At $1 per strip, manf earn about 70-80% margin on test strips. They can reduce their margins, still make good money, and the ‘middleman’ distributors can either keep the wholesale cost savings (since they claim they are so thin) or pass the savings along to the customer.

    It sounds to be like some people are afraid of losing profit so they are rattling the chains of some long term consequence to get the end users to protest.

    In addition, all of this assumes that the market cannot bear these costs, which per above it can. And it cannot change and evolve – which is something our economy is very good at. An easy example, get rid of the distributors. have the goods bought and sold directly from the manf. There are still expenses involved, but less of a price hike as there is one less party adding profit to the product. Internet purchasing makes this a much more possible scenario and I would be surprised if it is not already in play or at least planning stages.

    Here is another opportunity for the marketplace to flex and evolve: the GenStrips Diabetes Mine wrote about in Dec 2012. As a consumer, I would welcome this new lower priced competitor into the marketplace. Will they be sunk by legal crap? Maybe – by the same people who will whine about not being able to make enough money off of diabetes test strips. Of course they do not want to share their locked up market.

    Reducing choice based on low margins is a simple economics lesson and it does happen, but I do not think that is the case here…look at the Time Magazine article from the Mar 4 2013 issue titled, ‘Bitter Pill.’ The whole healthcare industry needs an overhaul. I am not a fan of centralized anything, let alone medical care. However, we are being taken for a ride and this ‘alarm’ is just one more way we are being manipulated because we need these meds and have not exercised our influence in the market. Perhaps this move is the warm up to our full healthcare work out, where the consumer finally gets to dictate product features, cost, and quality.

    So if I understand that the argument is that the costs are too low and will end up reducing choice, I reject that argument and insist that the diabetes gear providers – from researchers, to manufacturers, sellers, doctors, insurance companies, and anyone else involved STOP MAKING UNETHICAL LEVELS OF PROFIT OFF OF MY CHRONIC ILLNESS. Go earn your billions in scented hand lotion or anything else that is not vital to survival.

  4. Joseph
    Joseph March 11, 2013 at 10:52 am | | Reply

    Why are the suppliers upset? If Medicare is paying 80%, then the $10 copay means each 50 test strip bottle is $50, a reasonable price. I pay less then that, with a 20% copay, for the Contour NEXT test strips through Medtronic. Maybe I’d have more sympathy if it weren’t for my experiences going through DME suppliers for CGMS/Pump supplies.

    If this spreads to private plans, then I can’t see my choices getting more limited, since I’m already limited for my pharmacy benefits to two meter companies as is.

  5. Type1EngStudent
    Type1EngStudent March 11, 2013 at 3:57 pm | | Reply

    This is not a bad thing.

    When you test your blood glucose, you are putting your blood on an electrode, that is probably reacting with glucose dehydrogenase. There is nothing innovative about test strips in principle.

    Medicare should not be rewarding test strip manufacturers for antiquated technologies.

    And, guess what, any engineer can figure out how to program all of those “neat” features on meters and insulin pumps, such as area under curve (AUC), daily bg average, standard deviation. It does not take talent. It however, makes a lot of money.

    If the quality of meters and test strips (and even other types of DME) were actually substantially improving and emerging, I would be protesting Medicare’s lack of reimbursement for DME. But, guess what, it’s not.

  6. Jay Kauffman
    Jay Kauffman March 11, 2013 at 7:39 pm | | Reply

    Let us please not offend these fragile, saintly test strip companies and diabetes supply companies that depend for their survival on minimal profit margins of 70 to 80 percent in the interest of staying on top of the economic heap, an absolute necessity in this survival of the fittest economy.

    They exist only so they can continue to serve us who depend on their benevolence.

    Surely they only raise prices with merciless constancy on products that take little true innovation to produce so that they can continue their holy mission to help those of us who have no choice but to grin and pay if we wish to survive as well, in the more corporeal sense of the word, of course.

    These saintly corporate entities need to be coddled and kowtowed to by anyone with a right mind.

    Yes, they must thrive if we are to barely survive!

    In no way should we ever suggest or even imply let alone threaten the idea of price controls or any such thing as human-based compassion as a basis for policy, nay, for fear of upsetting the entire brilliantly successful medical economic ecosystem.

    This system has made so many deserving people rich and comfortable while only causing a very minimal percentage of US bankruptcies ( 60+% of US bankruptcies is caused by medical bills is such a small price to pay as a nation)

    It has even kept hospital bills for the uninsured down to the point where they can actually, thankfully afford to pay up to 12% IN FULL if they struggle hard enough, grin and bear the debt collector’s friendly reminders, and don’t go bankrupt or keel over before reaching such a high mark.

    If we try to change anything in this natural and holy medical marketplace, particularly in favor of those who suffer the most and bear the worst indignities, we surely risk making it even worse for them and for everyone else as well, and risk is a thing to be dreaded, unless you are too big to fail, in which case your failure will be taken out on those who are to small to succeed.

    So please remember, they depend on us to depend on them for survival, and please, just don’t rock the boat! There are not enough lifeboats and if we cause too many waves more of us might get tossed overboard so the whole thing can continue to float!

  7. Jeffrey S
    Jeffrey S March 14, 2013 at 6:34 am | | Reply

    As always with medical products companies it is the bottom line that is most important to them, so investment in R&D will definitely go down – which will have a negative effect on developing new and better products and devices for diabetics. Can the US government not force these companies to spend a larger percentage of their profits on R&D?

    1. jim
      jim November 17, 2013 at 7:28 am | | Reply

      Sorry to sound a bit negative, but I don’t like being “forced” to do anything. Do you? Forcing a company to do something is “communist speak”. We were gifted a “free” land. And it can remain such if we don’t “Force” people and companies to do thing but instead let them choose. There is a great dynamic – if it’s profitable to do, it will get done. If it’s profitable to make test strips cheaper, someone will do it. The government doesn’t need to force them. If it’s profitable to spend more on R&D, then they will do it, but if the government forces them to sell things cheaper and the incentive to spend less on R&D is reduced, then it’s the governments own actions, forcing things, that causes the problem.
      There is a consequence in all things the government does. All government action causes inefficiencies in the market. The question then becomes, are we willing to accept the inefficiencies. Typically, if people knew the real inefficiency, the answer would be NO. In this case, the inefficiency is reduced R&D, fewer products in the future to help us, long term fewer doctors to serve us (unless the government “forces” people to be doctors). The list of negatives goes on and on.
      I’d like to see the government stay out of private business, and stay in public protection. Government focus should be on defense, boarder protection, and such. Unfortunately, they do much too little in the area of their responsibility and much to much in the areas they should stay out of.

  8. AC
    AC March 15, 2013 at 3:20 am | | Reply

    The major drawback of low priced diabetes supplies is that insurers will only pay for those items offered by selected contract suppliers. The company will choose them mainly for cost reasons. This will result in a hinge in accessibility of D-supply more on the choices of insurers as compared to the patients.

  9. Sam
    Sam March 24, 2013 at 7:49 pm | | Reply

    Government Rationing of healthcare. This is just the tip of the iceberg. Wait til Obamacare kicks in. Competition is going to be out the window as fewer companies can manage to continue in the business. Don’t believe it? Check how many MDs are either retiring early due to Obamacare or are just not going to take Medicare patients anymore. It IS happening all over. Obamacare robbed from Medicare making huge cuts. Everyone who championed Obamacare thinking “free healthcare to all” was naive and now we all will have to pay the price. The diabetes market is just a small part of it. The DME industry is huge and serves millions of seniors on Medicare who need these products. The DME companies cannot make a profit on these cuts. And all you simpletons who think they are all evil big suppliers are naive. The so called evil big suppliers are the ones who are big enough to survive the cuts. The smaller ones cannot and will be forced to get out of the market. Therefore the evil big companies will have monopolies and their customer service will be even worse than it is now. Think US Post Office type of service or VA Medical Centers. Anyone want to use those over Johns Hopkins or FedEx/UPS when you must get a package delivered overnight. I think not. We are doomed to mediocre healthcare unless we wise up before it is too late and repeal this bad law, aka Obamacare. Remember Polosi, “you have to pass the bill to know what is in it” Well, guess we are finally starting to find out what is in it. Just a darn shame.

    The title of this says it all. Prices dropping not a good thing. Remember, there is no such thing as a free lunch. And my healthcare is much more important than a lunch.

  10. kevinlmcmahon
    kevinlmcmahon March 24, 2013 at 9:42 pm | | Reply

    My prediction: In the fallout of Obamacare and ACO’s, a new breed of specialized health plans will emerge mostly in part due to the recent availability of automated biometric patient medication adherence data collection as a method of delineating those patients who strive for better health by doing those proscribed behaviors and those who are diagnosed with the same condition and choose not to. I had this thought a long time ago but the current situation is ripe for an innovative approach.

  11. Naomi Taylor
    Naomi Taylor May 1, 2013 at 9:11 am | | Reply

    It’s hard for me to wrap my head around how complicated (and expensive) life can be for diabetics! I am lucky enough to currently be on both medicare and medicaid so I am (for the time being) getting my strips for free. Before I was approved for these programs, I struggled constantly to afford my strips and was tickled to death when Walmart came out with their $9 test strips. Although not 100% accurate, they are better then my past efforts of (sometimes) “guessing” my BG. That being said, even with my current compo of medicare and medicaid there are constant hoops I have to jump through to get my strips. Medicare only wants to cover testing 3 times a day. Being a extremely brittle diabetic, I test more like 8-10 times a day. Letters/referrals from two different doctors and faxing my BG logs seem to keep them happy, so I do what they ask and enjoy not having to miss meals so that I can afford my test strips/medication. With the cost of brand name prescriptions rising (13% from September 2011 to September 2012), I will gladly take any cuts I can get. And while having to track down test strips will be very inconvenient, diabetics will track them down to the ends of the earth, because they play a huge role in keeping us healthy.Its hard to know if the price drop will be good or bad for the diabetic community. I can only hope that it will be for the best.. we need some good news now and then.

  12. Jared Cooper
    Jared Cooper May 10, 2013 at 5:57 am | | Reply

    I work at a durable medical supply company in rural southern Illinois. We have supplies diabetic testing supplies for over 30 years. Unfortunately, we have made the decision to let our patients know that we are getting out of diabetic supply business for good. Companies cannot operate on the margin Medicare is pushing on us. The cost of any decent test strip is more than the allowable fee, not to mention intake payroll, billing payroll, and keeping up with the ever increasing documentation demands. Sure the patient thinks lowering fees is a good thing, until they can’t find any reputable company to service them. Goodbye customer service! People around here will likely have to drive 45 minutes or more just to get some no name test strips that aren’t accurate. Even worse, they will get hooked up with a mail order company. You should hear those horror stories.

  13. Jenifer
    Jenifer June 25, 2013 at 9:53 am | | Reply

    Yes. I do agree with you, and that’s why we need to use good products that are good for us. I am personally using Precious portion’s products and really these products help me a lots to change my life, to control my body.

  14. Julian Heyward
    Julian Heyward July 23, 2013 at 6:08 pm | | Reply

    Hello from New Zealand we are facing now, after policy changes and going to a sole supplier of blood glucose meters and strips, purely based on cost, huge issues with accuracy of the new meters – usually on the high side with the consequence of type-1′s adjusting our doses higher with resulting hypoglycemic reaction. See link below -

    Thank you.

  15. The Diabetes Test Strips Crisis: How Cutting Costs Is Robbing Your Health

    [...] Hoskins, at says all “PWDs (people with diabetes) will have less choice (of meters and strips) and an [...]

  16. jim snell
    jim snell July 27, 2013 at 9:51 pm | | Reply

    I must be stupid. Why is the government interfering with our free enterprise system. If they want to only pay $ 10 a vial at 80 %; fine do so but let people buy any strips they want but only get re-inbursed at the $ 10 rate and pay extra for any overage.

    This Russian gulag approach is absolutely hideous and for what good reason.?

    I see no dam good reason for why the government should be selecting winners/losers – 18 rock bottom suppliers only allowed to bill medicare and then do not offer choices of strips to the diabetics.

    Who is the idiot control freak who has mandated this byzantine system and no choice?

    If they really are trying to shut down the whole mess; this would seem an excellent approach.

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