Australian diabetes organisations are appealing to the federal government for an additional $405 million in funding over the next four years to expand subsidised access to continuous glucose monitors and automated insulin delivery systems for priority groups.
Joint pre-budget submissions, backed by ten research and lived experience bodies including Diabetes Australia and the Australian Diabetes Society, say the funding is crucial for boosting health equity and would deliver billions of dollars in returns over the coming decades.
While CGMs and AID systems were now part of international best practice for diabetes management, Australian patients were forced to face a “widening gap between what we know works and what people can afford,” Diabetes Australia group CEO Justine Cain said.
Associate Professor Sof Andrikopoulos, CEO of Australian Diabetes Society, said the submissions were the first step in technology access for all Australians with diabetes.
“Equitable and affordable access to diabetes-management technology is critical to providing effective care for people with diabetes and the cornerstone of advocacy for the Australian Diabetes Society,” he said.
Associate Professor Sof Andrikopoulos.
A key recommendation is to subsidise AID systems for 38,000 Australians with type 1 diabetes, at a price tag of $298.95 million over four years.
The funding would apply to children and young adults aged under 21, those experiencing socioeconomic disadvantage, Aboriginal and Torres Strait Islanders and those pregnant or planning pregnancy.
Modelling projected the AID program would result in $4.38 billion in net benefits by 2066, including increased workforce productivity, avoided hospitalisations and improved quality of life for patients.
Benefits to expanded AID use included reduced hospitalisations and better mental health and productivity for patients.
“It can also reduce the fear of hypoglycaemia, diabetes-related distress and depressive symptoms. These benefits can be life changing for people living with type 1 diabetes,” the submission said.
Bringing CGMs to more patients
The sector also recommended subsidising continuous glucose monitors for an additional 16,000 Australians with type 2 and ‘other’ types of diabetes requiring insulin.
This plan would cost $106.48 million over four years but deliver a $2.69 return for every dollar invested in the long run, modelling suggested.
The CGM proposal would target priority populations including those who were pregnant, patients with other forms of diabetes like type 3c, healthcare card holders, Aboriginal and Torres Strait Islander patients and those under 21.
The benefits of the government’s 2022 funding of CGMs for type 1 diabetes patients were already being felt, the submission argued, but access for type 2 diabetes patients was currently limited to those who could afford the $2,000 to $4,000 in annual costs.
The push for expanded CGM access has been in the works for some time, with device makers Abbott Australasia and Australasian Medical & Scientific Limited applying for public funding for the Dexcom ONE+ and Freestyle Libre for certain patients with type 2 diabetes last year [link here].
But the Medical Services Advisory Committee (MSAC) questioned whether the evidence presented actually showed CGMs delivered clinically meaningful improvements in glycaemic control. The committee sent both companies back to the drawing board to provide more data before a decision was made about funding.
Both companies said at the time they remained committed to working with the department of health to extend CGM access.
In their submission, diabetes organisations argued the benefits of CGM use extend beyond clinical improvements. The monitors also helped boost positive lifestyle changes, lower the rate of hospitalisations and could make healthcare appointments more efficient.
“As well as acting as a behaviour modification tool, CGMs can improve ongoing self-management, reduce diabetes distress and assist healthcare professionals in making therapeutic decisions,” the groups said.