About half of the people with Type 1 Diabetes in Australia are eligible for subsidised CGM through NDSS. Broadly speaking, that’s people who are under 21, have concession status, or are pregnant (there is a little more detail to it).
For a while Dexcom G6 has only been subsidised for people using the Tandem t:slim X2 pump (which relies on it). But that’s finally changing at the 1st of March 2022. And this affects those of us NOT eligible for the NDSS subsidy too!
The new world (as from March 2022)
Anyone registered with NDSS to receive Dexcom G5 will apparently be automatically upgraded to G6.
Sales of the Dexcom G5 (outside NDSS) will immediately cease! No new sensors or transmitters will be available.
The eligibility criteria for the NDSS CGM Subsidy has not been changed.
The impact
Of course, there are still plenty of G5 transmitters around: it’s easy to replace the batteries in “expired” transmitters and refresh them. But once people’s stocks of G4/G5 sensors finally run out, there will be no more.
The cost for self-funded G5 users is likely to go up. Each G6 sensor costs $110 (vs $92.50 for a G5 sensor). Although the official lifespan of a G6 is 10 days (vs 7 days for a G5) many people find they get longer out of the G5 sensors.
Personally I’ve been getting an average of 16-18 days out of both types, so G6 is more expensive for me. Mind you, I do find it more convenient to use.
The Dexcom G6 system is supported by lots of software, but there will be forced change for many people.
- Tandem’s t:slim X2 pump uses the G6 for its current Basal-IQ and for the upcoming Control-IQ AID system.
- Tandem users who have not upgraded their firmware to Basal-IQ will be forced to upgrade in order to keep accessing CGM. This suits AMSL and the TGA anyway, as the old pump is no longer TGA-approved.
- Ypsomed’s Mylife app (which talks to the YpsoPump) talks directly to Dexcom G6 transmitters (although the Dexcom component of it is picky about which phone models are supported).
- Dexcom’s own G6 app runs on iPhones and select Android phones, although it can be picky about operating system upgrades. Luckily there are some workarounds for this.
- xDrip+ on Android phones supports both G5 and G6. It’s been my go-to CGM solution for many years.
- Spike on iPhones does not support G6.
- xDrip4iOS has recently gained G6 support.
It was going to happen one day
The G4 and G5 share the same sensor, and where Dexcom has introduced G6 around the world they’ve gradually been discontinuing these older systems.
G4 disappeared from NDSS last year, but as many government-funded (via NDSS) CGM users were not able to access G6, the G5 remained. That restriction has finally gone, and it’s interesting to see how quickly the G5 is being closed down.
‘And this affects those of us NOT eligible for the NDSS subsidy too!’ But how? If you don’t have a concession card, aren’t under 21, aren’t in the planning stages of pregnancy, aren’t pregnant, or aren’t 3 months post-partum, how are we affected? If anything, discriminated against again for our age, life stage, or ability to ear over $18,000 annually.
It affects us because the G5 option (which is slightly cheaper than G6 for many people) is going away.
Quite apart from the simple fact that having different options does affect us, I know there are people who have been able to scrounge together enough money to afford G5 but who will now have to reconsider if they can afford to keep using CGM. Even though the health impact of NOT using it can be significant. Or they have to look at other systems such as Libre (which is not a 1:1 replacement).
Granted for people who have not been able to access any CGM yet, the impact is more of changing the imaginable possibilities rather than immediate change. Having government CGM support for everyone will improve the prospects for some of us more radically than others.
But we keep waiting for news on that…