Persistent heterogeneity in diabetes technology reimbursement for children with type 1 diabetes: The SWEET perspective.


Journal

Pediatric diabetes
ISSN: 1399-5448
Titre abrégé: Pediatr Diabetes
Pays: Denmark
ID NLM: 100939345

Informations de publication

Date de publication:
06 2019
Historique:
received: 26 07 2018
revised: 25 10 2018
accepted: 28 01 2019
pubmed: 19 2 2019
medline: 24 3 2020
entrez: 19 2 2019
Statut: ppublish

Résumé

Frequent use of modern diabetes technologies increases the chance for optimal type 1 diabetes (T1D) control. Limited reimbursement influences the access of patients with T1D to these modalities and could worsen their prognosis. We aimed to describe the situation of reimbursement for insulins, glucometers, insulin pumps (CSII) and continuous glucose monitoring (CGM) for children with T1D in European countries participating in the SWEET Project and to compare data from EU countries with data from our previous study in 2009. The study was conducted between March 2017 and August 2017. First, we approached diabetes technology companies with a survey to map the reimbursement of insulins and diabetic devices. The data collected from these companies were then validated by members of the SWEET consortium. We collected data from 29 European countries, whereas all types of insulins are mostly fully covered, heterogeneity was observed regarding the reimbursement of strips for glucometers (from 90 strips/month to no limit). CSII is readily available in 20 of 29 countries. Seven countries reported significant quota issues or obstacles for CSII prescription, and two countries had no CSII reimbursement. CGM is at least partially reimbursed in 17 of 29 countries. The comparison with the 2009 study showed an increasing availability of CSII and CGM across the EU. Although innovative diabetes technology is available, a large proportion of children with T1D still do not benefit from it due to its limited reimbursement.

Sections du résumé

BACKGROUND
Frequent use of modern diabetes technologies increases the chance for optimal type 1 diabetes (T1D) control. Limited reimbursement influences the access of patients with T1D to these modalities and could worsen their prognosis. We aimed to describe the situation of reimbursement for insulins, glucometers, insulin pumps (CSII) and continuous glucose monitoring (CGM) for children with T1D in European countries participating in the SWEET Project and to compare data from EU countries with data from our previous study in 2009.
METHODS
The study was conducted between March 2017 and August 2017. First, we approached diabetes technology companies with a survey to map the reimbursement of insulins and diabetic devices. The data collected from these companies were then validated by members of the SWEET consortium.
RESULTS
We collected data from 29 European countries, whereas all types of insulins are mostly fully covered, heterogeneity was observed regarding the reimbursement of strips for glucometers (from 90 strips/month to no limit). CSII is readily available in 20 of 29 countries. Seven countries reported significant quota issues or obstacles for CSII prescription, and two countries had no CSII reimbursement. CGM is at least partially reimbursed in 17 of 29 countries. The comparison with the 2009 study showed an increasing availability of CSII and CGM across the EU.
CONCLUSIONS
Although innovative diabetes technology is available, a large proportion of children with T1D still do not benefit from it due to its limited reimbursement.

Identifiants

pubmed: 30773756
doi: 10.1111/pedi.12833
doi:

Substances chimiques

Blood Glucose 0
Hypoglycemic Agents 0
Insulin 0

Types de publication

Comparative Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

434-443

Investigateurs

N Papo (N)
D Kownatka (D)
Silvia Lion (S)
P Gerhardsson (P)
T Kalina (T)
B Rami-Merhar (B)
J Svensson (J)
R Hanas (R)
M Knip (M)
M Witsch (M)
R Verkauskiene (R)
S Todorovic (S)
P Toth-Heyn (P)
M Ng (M)
J Pelicand (J)
K Podolakova (K)
B Timar (B)
K Casteels (K)
R Cordona Hernandez (R)
H Hoey (H)

Informations de copyright

© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Auteurs

Zdenek Sumnik (Z)

Department of Pediatrics, Motol University Hospital, Prague, Czech Republic.

Agnieszka Szypowska (A)

Department of Pediatrics, Medical University of Warsaw, Warsaw, Poland.

Violeta Iotova (V)

Department of Pediatrics, Medical University-Varna, UMHAT "Sv. Marina", Varna, Bulgaria.

Natasa Bratina (N)

Department of Endocrinology, Diabetes and Metabolism, UMC, University Children's Hospital, Ljubljana, Slovenia.

Valentino Cherubini (V)

Department of Women's and Children's Health, Azienda Ospedaliero-Universitaria, Ospedali Riuniti di Ancona, "G. Salesi" Hospital, Ancona, Italy.

Gun Forsander (G)

Institute for Clinical Sciences, Dept of Ped, University of Gothenburg and the Queen Silvia Children's Hospital, Sahlgrenska Univ. Hospital, Gothenburg, Sweden.

Sujata Jali (S)

Department of Pediatrics, KLE University's Jawaharlal Nehru Medical College Belgaum, Belgaum, India.

Joao Felipe Raposo (JF)

APDP-Diabetes Portugal and Nova Medical School, Lisbon, Portugal.

Gordana Stipančic (G)

Department of Pediatrics, University Hospital Center "Sestre milosrdnice", School of Dental Medicine, University of Zagreb, Zagreb, Croatia.

Andriani Vazeou (A)

Department of Pediatrics, Diabetes Center, P & A Kyriakou Children's Hospital, Athens, Greece.

Henk Veeze (H)

Diabeter, Rotterdam, The Netherlands.

Karin Lange (K)

Department of Medical Psychology, Hannover Medical School, Hannover, Germany.

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