At the 2019 Australasian Diabetes Congress (last week) no announcements were made about Dexcom G6. It’s still waiting for approval from the TGA before AMSL will be able to start selling or even marketing it. The strongest story I heard was just “hopefully before the end of 2019”.
But in the last few days some news has come to hand about improved availability of the Dexcom G5 CGM! And not from AMSL (the distributor).
Previously the only official way to purchase G5 sensors and transmitters was through AMSL. The prices can be seen in their online store. Or, if you’re one of the minority of people currently eligible for NDSS CGM subsidy, you get to access them for free (with quantity limits) through your NDSS Access Point (pharmacy).
Use your pharmacy!
Now people have discovered that you can purchase them through your pharmacy without invoking NDSS.
It seems that when someone places an NDSS order for CGM through the pharmacy, the pharmacy “sells” them the product but invoices the cost to NDSS (a “reimbursement” process). If you talk to your pharmacy you can usually order the product and pay the cost yourself. And the cost is usually below the price that AMSL have been charging you!
At pharmacies around Australia, people have been able to order a box of G5 sensors (which AMSL charge $370 for) for prices that vary between $250 and $500. Yes, strangely some pharmacies have wanted $500! In that case just go to a different pharmacy.
The best prices seen so far have been through My Chemist, Chemist Warehouse (who are part of the same chain as My Chemist), and National Pharmacies. Others may have similar prices of course.
I checked out the prices though my local My Chemist, and then extrapolated the overall system cost:
|AMSL price||Pharmacy price|
(lasts ~3 months)
|Box of 4 sensors
|Annual price at warrantied intervals
13 boxes of sensors, 4 transmitters
This is a massive cost saving! Interestingly, this seems close to the “research”/hospital pricing that AMSL used to offer.
Hopefully this will enable more people to access Continuous Glucose Monitoring!
CGM provides so much insight into what our glucose levels do (as well as give us alarms to protect us against hypoglycaemic events) that I regard them as one of the most important technology tools for diabetes.
Talk to your pharmacy
To take advantage of this, don’t try to look up the Dexcom products on your pharmacy’s website. Go into your pharmacy in person, and talk to the pharmacist. Get them to look up the “Dexcom” products on their computer. Even the G4 transmitters will come up as an option, although you’re probably only interested in the G5 Transmitter and the G4/G5 Sensor (which is a box of 4 sensors).
Don’t try to process the order as an NDSS order (they may say “you can get this through NDSS”) unless you’re eligible for the CGM subsidy. Just place an ordinary order for the product (if their price is acceptable) and it will probably arrive within a day or two if they don’t have any on the shelf.
If their price is not acceptable, try a different pharmacy (see above).
Sell more for less?
It will be interesting to see over time if this improved pricing allows AMSL/Dexcom to make more money by selling more units at lower pricing. The “sell more for less” argument is used a lot, but seeing it in action will allow them to measure actual effects.
Because we have to self-fund our CGMs, many of us have of course explored how to reduce the costs.
Many people (myself included) now use G5 transmitters where we’ve replaced the batteries and reset after 3 months. They’re no longer warrantied medical devices, but they work just fine and the cost to rebattery can range from $10 to $80 depending on how much of the work you want to do yourself.
And many people use their sensors for longer than the 7-day warrantied period. Of course we’re still calibrating several times a day so we get to see when the accuracy drops off.
My personal average over the last 12 months has been 26 days per sensor, although my record was 58 days. At 23 days per sensor I only need 4 boxes per year, which at the new pricing brings my annual CGM cost down to just over $1000! This is significantly cheaper than Libre, which at ~$2500 per year is on paper the cheapest “CGM” although it doesn’t offer real-time alarms.
Diabetes is an expensive-enough condition to live with anyway, all cost savings are welcomed.
And if it enables more people to access life-saving technology then so much the better!
Kids under 21 and a limited number of people with “high clinical need” and health concession status can currently get CGM with 100% subsidy through NDSS. Hopefully the NDSS support will grow (possibly including partial subsidy for everyone). But in the meantime we have to pay.
Some people have been wondering if this cheaper G5 access is a harbinger of the introduction of G6 at a higher price. Time will tell, but meanwhile we should rejoice at any benefit we get in dealing with this very expensive health condition that none of us asked to get!