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December 15, 2017

Dexcom, Ascensia Reach Deal for Medicare Diabetes Bundle

Mary Caffrey
The agreement paves the way for those over age 65 to gain access to continuous glucose monitoring, following a historic policy change.
Ascensia Diabetes Care and Dexcom have reached an agreement that should soon speed delivery of Dexcom’s G5 continuous glucose monitoring (CGM) system to eligible Medicare beneficiaries.

The deal gives Dexcom a partner for creating the “bundle” of a CGM and blood glucose monitoring system, which will meet Medicare shipping requirements and give access to those who meet CMS criteria for the system.

Earlier this year, Medicare announced it would pay for the Dexcom G5 for beneficiaries with diabetes who take insulin, use a home blood glucose monitoring system (BGMS), and perform finger stick tests at least 4 times a day. This covered virtually everyone with type 1 diabetes (T1D) and many with advanced type 2 disease (T2D).

For those who rely on CGM, this was historic news. Previously, turning 65 meant paying for the device out of pocket or giving up a tool that had helped bring unprecedented levels of glycemic control. Dexcom and advocacy groups like JDRF had worked for years on the policy change, which began with a July 2016 FDA hearing to show that it was safe to use the Dexcom G5 for dosing decisions. The Dexcom model is the only one approved by FDA for therapeutic use, which cleared the way for it to be covered by Medicare.

But the good news hit a snag when Medicare suppliers refused to ship the Dexcom G5. They wanted to know how to follow rules that require diabetes supplies to be shipped in a set, or “bundle.” Because Dexcom doesn’t make the blood glucose monitoring system needed to calibrate a CGM, it had to find a partner to meet requirements.

According to a statement from Ascensia, “The complete bundle will be available to people who are covered by Medicare and quality for therapeutic CGM.” Ascensia Diabetes Care’s Contour Next One BGMS will be included in the bundle. While separate blood glucose tests are no longer needed for each dosing decision, they are still needed twice a day to calibrate the CGM.

“For those people with diabetes who are eligible to receive the G5 through Medicare, Ascensia is thrilled to become the partner of choice for calibration of the Dexcom G5 CGM system,” said Robert Schumm, vice president and managing director of Ascensia Diabetes Care. “We believe this combination will help improve diabetes management for people on Medicare who are eligible for therapeutic CGM.”

Dexcom hailed the agreement as well. “In Ascensia, we saw a business partner that matches our own commitment to best-in-class products and services for people with diabetes. With this agreement, we are pleased to begin offering a complete bundle to Medicare-eligible patients, enabling access to the Dexcom G5 CGM system as efficiently as possible.”

 
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