Study outlines access issues for insulin pumps

Friday, March 20, 2015

CHICAGO – A recent survey by the American Association of Diabetes Educators found that beneficiary access to insulin pumps and supplies in Round 1 bid areas is “a little worse than expected.”

“From our perspective, we figured there’d be some element of access issues, but it was a little worse than what we expected,” said James Specker, director of federal and state advocacy for the AADE.

Insulin pumps and supplies were included in a new infusion category as part of the Round 1 re-compete of competitive bidding. At the time, industry stakeholders said that the devices should not be lumped together with home infusion therapy because providers of one therapy typically don’t provide the other. 

Of 29 contract suppliers contacted by phone, the survey found that only 17 (58%) carried insulin pumps and 18 (62%) carried replacement supplies and reservoirs. Among those who do offer pumps and supplies, many only carry one brand.

That may be due to unclear guidance from CMS, says Specker.

“Regarding the competitive bid process, we learned from suppliers that many had been unaware that insulin pumps were included in the infusion category,” he said. 

Although the current number of beneficiaries who use insulin pumps is small, that will change, says Specker.

“We’ll see those numbers increase, which is why we are looking at this now and for the future,” he said. “Front-end cost savings (achieved through competitive bidding) could actually cost more in the long run if people have access issues or have to change their care.”

The association has done similar studies—with similar results—on the impact of competitive bidding on diabetes testing supplies.

“Going back to the first study we did, there is this illusion that competitive bidding is working perfectly in CMS’s eye and that they are not hearing of any problems,” he said. “That doesn’t make a whole lot of sense from what we are hearing from a number of groups.”