Persistent heterogeneity in diabetes technology reimbursement for children with type 1 diabetes: The SWEET perspective

Pediatr Diabetes. 2019 Jun;20(4):434-443. doi: 10.1111/pedi.12833. Epub 2019 Apr 11.

Abstract

Background: Frequent use of modern diabetes technologies increases the chance for optimal type 1 diabetes (T1D) control. Limited reimbursement influences the access of patients with T1D to these modalities and could worsen their prognosis. We aimed to describe the situation of reimbursement for insulins, glucometers, insulin pumps (CSII) and continuous glucose monitoring (CGM) for children with T1D in European countries participating in the SWEET Project and to compare data from EU countries with data from our previous study in 2009.

Methods: The study was conducted between March 2017 and August 2017. First, we approached diabetes technology companies with a survey to map the reimbursement of insulins and diabetic devices. The data collected from these companies were then validated by members of the SWEET consortium.

Results: We collected data from 29 European countries, whereas all types of insulins are mostly fully covered, heterogeneity was observed regarding the reimbursement of strips for glucometers (from 90 strips/month to no limit). CSII is readily available in 20 of 29 countries. Seven countries reported significant quota issues or obstacles for CSII prescription, and two countries had no CSII reimbursement. CGM is at least partially reimbursed in 17 of 29 countries. The comparison with the 2009 study showed an increasing availability of CSII and CGM across the EU.

Conclusions: Although innovative diabetes technology is available, a large proportion of children with T1D still do not benefit from it due to its limited reimbursement.

Keywords: children; diabetes technology; reimbursement; type 1 diabetes.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Blood Glucose / analysis
  • Blood Glucose Self-Monitoring / economics
  • Blood Glucose Self-Monitoring / instrumentation
  • Child
  • Child, Preschool
  • Cost of Illness
  • Costs and Cost Analysis
  • Diabetes Mellitus, Type 1 / blood*
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Diabetes Mellitus, Type 1 / economics
  • Diabetes Mellitus, Type 1 / epidemiology
  • Equipment and Supplies / economics*
  • Europe / epidemiology
  • Humans
  • Hypoglycemic Agents / administration & dosage
  • Hypoglycemic Agents / economics
  • Infant
  • Infant, Newborn
  • Insulin / administration & dosage
  • Insulin / economics
  • Insulin Infusion Systems / economics*
  • Insurance, Health, Reimbursement* / economics
  • Insurance, Health, Reimbursement* / statistics & numerical data
  • Insurance, Health, Reimbursement* / trends
  • Inventions / economics
  • Inventions / statistics & numerical data
  • Inventions / trends
  • Longitudinal Studies
  • Young Adult

Substances

  • Blood Glucose
  • Hypoglycemic Agents
  • Insulin