Barriers prevent access to new diabetes treatments

Sunday, October 31, 2004

WASHINGTON - Although research touts the importance of insulin management in treating Type 1 diabetes, a recent report concluded that payers continue to pose access barriers for patients needing insulin pumps and other therapies.

These finding emerged from a panel run by The Health Strategies Consultancy and the Center for Insulin-Dependent Diabetes Access.

“There has been a lot of research done about diabetes care and the success of intensive insulin management in improving conditions and outcomes for Type 1 diabetes patients,” said Sarah Pitluck, of the Health Strategies Consultancy and one of the report’s authors. “So, the big question for the panel was why the research was not being adopted.”

The panel, made up of Medicare carriers, private payers, researchers and patient groups, found that there was a clear disconnect in communication between providers and payers concerning treatments.

“Since there is no standard for intensive insulin management in the services that physicians and providers give, payers are saying that they don’t know what they should pay for or how to assign values,” said Pitluck.

A lack of data pointing specifically to what outcomes are improved by insulin management and what technologies create those results also contribute to access issues. The panel agreed that more research is needed in order to “get everyone on the same page,” said Pitluck.

“If we can’t get reimbursement for the services that are on the market right now, it’s going to be even more difficult to get new technologies paid for and to ensure patients have access to them as well,” she said.