The Medical Services Advisory Committee (MSAC) has deferred advice on the public funding of two CGMs for people with type 2 diabetes dependent on insulin.

The committee considered applications at the end of July 2025 regarding the National Diabetes Services Scheme. The proposals were submitted by Abbott Australasia for its FreeStyle Libre 2 product and by Australasian Medical & Scientific Limited for the Dexcom ONE+.

However, MSAC requested both companies return with stronger evidence regarding benefits for glycaemic control in specific patient populations and advised them to revise their economic modelling.

Abbott Australasia’s application sought funding for the FreeStyle Libre 2 and the ‘Plus’ variant for people with T2D requiring insulin, pregnant women with gestational diabetes, and those over 21 with conditions similar to T1D requiring insulin. These CGMs are already subsidised under the scheme for patients with type 1 diabetes.

While the committee noted a large volume of public feedback, where a major theme was “the importance of supporting self-management through patient education and empowerment”, it found the clinical data insufficient.

Crucially, MSAC rejected the claim that the CGM systems led to a clinically meaningful improvement in glycaemic control based on the data presented.

“The trials were relatively small, short term, and did not report end-organ outcomes. The reduction in HbA1c was lower than the level considered a meaningful improvement by the Pharmaceutical Benefits Advisory Committee and regulatory agencies,” the committee stated.

The application suggested CGMs helped patients achieve a reduction in HbA1c that was 0.3% greater than self-monitoring blood glucose tests. However, the committee noted that the previously accepted non-inferiority margin or smallest difference needed to show an improved clinical outcome was 0.5%.

“The follow-up time in the studies was also relatively short (1 year or less), so MSAC considered that the long-term benefits of CGM were not shown in these studies,” the public summary document stated.

The economic case also faced scrutiny. MSAC said the modelling to support the claim “lacked face validity and could not be used to reliably establish cost-effectiveness,” noting that different subpopulations of T2D patients likely represented different levels of cost-effectiveness.

“MSAC therefore advised that a revised resubmission should focus on the subpopulations who have a greater clinical need for CGM and are more likely to benefit from CGM, as well as presenting evidence around two different patterns of usage, and any more recent clinical evidence of effectiveness,” the committee advised.

Australasian Medical & Scientific Limited’s application for the funding of Dexcom ONE+ for patients with insulin-dependent type 2 diabetes received similar feedback. The committee observed that claimed improvements in glycaemic control among this cohort were not fully supported.

“However, MSAC considered that CGM had other benefits for patients and T2D management. This includes empowering patients to manage their T2D and manage blood sugar levels during times of acute illness,” the committee said.

The company was advised to make a resubmission with revised economic modelling which focused on the populations with the highest clinical need.

“MSAC also considered revised estimates of utilisation would be required to more accurately estimate the size of the subpopulations,” the committee added.

Both companies stated they would continue to work with the Department of Health and MSAC to expand subsidised access.

“Recommendation 15 of the 2023 Parliamentary Inquiry into Diabetes identified insulin-using subpopulations as priority groups for [FreeStyle Libre] access, and this recommendation, recognised by the PICO Advisory Subcommittee (PASC), needs to be considered pragmatically by MSAC,” Abbott Australasia said in response.

Australasian Medical & Scientific Limited also reaffirmed its position: “Our goal is to ensure equitable access to CGM for all individuals with insulin-treated Type 2 diabetes, recognising the significant clinical and quality-of-life benefits this technology provides.”

The Limbic contacted both companies for comment on the resubmission process but did not receive responses prior to publication.