Author: Julia Vetsikas
This video resource highlights evidence—presented at the 83rd American Diabetes Association (ADA) Scientific Sessions—demonstrating the clinical, economic, and humanistic value of continuous glucose monitoring (CGM) in type 2 diabetes (T2D) for managed care and payer professionals. Abstracts presented in this video underscore the burden of hypoglycemia in T2D and the potential for CGM to improve clinical outcomes and manage disease-related costs regardless of treatment regimen or prescriber type. Key areas of focus pertinent to managed care and payer professionals include the benefits of CGM initiation on Healthcare Effectiveness Data and Information Set (HEDIS) measure performance, utilization of emergency department/hospital services, and patient adherence. This information is delivered in a multimedia infographic format, with quotes from managed care and payer key opinion leaders interspersed for maximum impact. The video concludes with a summary of best practices to facilitate streamlined coverage and access to CGM in alignment with the latest clinical evidence and expert recommendations.
This infographic highlights the value of CGM for positively impacting diabetes care quality, with special consideration given to underserved demographics of patients based on race/ethnicity and age. The piece links to the 2023 AMCP symposium moderated by Dr. Gary Puckrein, President and Chief Executive Officer of the National Minority Quality Forum, where diabetes care disparities and quality were also brought into focus. Also linked is an expert interview with Diana Isaacs, PharmD, with insights on disparities in diabetes care and quality considerations. Guidance is offered on improving CGM access as a means for meeting recent HEDIS quality measures tied to reducing emergency department and hospital use. Using findings from Blue Cross Blue Shield North Carolina as a case study, the infographic serves as a call-to-action for payers to remove manual prior authorizations for CGM under the pharmacy benefit.
Intended Audience: This activity is designed to meet the educational needs of medical directors, registered nurses, pharmacy directors, clinical pharmacists, specialty pharmacists, quality directors, as well as network physicians affiliated with various MCOs, health systems, and other payer organizations.
Credit Available: Up to 1.5 credit hours available for nurses (ANCC), pharmacists (ACPE), and physicians (AMA PRA Category 1 Credit™)
Expiration Date: October 31, 2024
Click Here to Begin!Educational Objectives
After completing this activity, the participant should be better able to:
- Assess clinical evidence and professional society guidelines for CGM systems in patients with type 1 or type 2 diabetes
- Characterize the impact of rtCGM on clinical measures of diabetes care
- Implement medical and pharmacy benefit design strategies to support appropriate access to rtCGM and develop evidence-based clinical criteria
Expert Faculty
Matthew D. Harman, PharmD, MPH
VP, Clinical Solutions, Employers Health
Diana Isaacs, PharmD, BCPS, BCACP, BC-ADM, CDCES, FADCES, FCCP
Endocrine Clinical Pharmacy Specialist, Co-Director, Endocrine Disorders in Pregnancy
Cleveland Clinic Endocrinology & Metabolism Institute
Gary A. Puckrein, PhD
President and Chief Executive Officer, National Minority Quality Forum
Drake Reiter, PharmD
Advisor, Pharmacy Product & Trend, Priority Health
Jointly provided by Impact Education, LLC, and Medical Education Resources.
This activity is supported by an independent educational grant from Dexcom, Inc.
Prescribing of CGM in clinical practice and payer coverage criteria have expanded considering the wealth of evidence and expert recommendations supporting more widespread use. As the body of evidence continues to grow, a new supplement in Diabetes Technology & Therapeutics offers insights from leading clinicians on the latest findings and practical application of CGM. The supplement highlights real-world evidence and the unique role of CGM in the management of hypoglycemia and enhancing behavior modification among users of the technology. Special consideration is given to the economic impact of CGM and access issues that may be of particular interest to payer and managed care decision makers.
The articles included:
Past, Present, and Future of Continuous Glucose Monitors Satish K. Garg
Continuous Glucose Monitoring Impact and Implications of Real-World Evidence: Past, Present and Future James R. Gavin III and Clifford J. Bailey
What Role Might There Be for Continuous Glucose Monitoring in the Assessment of Diabetes Risk? Eden Miller, William H. Polonsky and Kevin Miller
Practical Application of Continuous Glucose Monitoring in Clinical Practice: Case Studies Jeff Unger and Denise R. Franco
Advancements in Diabetes Technology Are Outpacing the Evidence Michael Rickson, Eugene E. Wright Jr., Anila Bindal and Laith Ghonim
One Size Fits All Versus Individualized Medicine in Type 1 Diabetes Management L. Kurt Midyett
Is Continuous Glucose Monitoring a Tool, an Intervention, or Both? Eugene E. Wright Jr. and Savitha Subramanian
Continuous Glucose Monitoring Use in Older Adults for Optimal Diabetes Management Medha N. Munshi
Personalized Glycated Hemoglobin in Diabetes Management: Closing the Gap with Glucose Management Indicator Timothy C. Dunn, Yongjin Xu, Richard M. Bergenstal, Watru Ogawa and Ramzi A. Ajjan
Prevalence, Cost, and Burden of Diabetic Ketoacidosis Naunihal Virdi, Yeesha Poon, Richard Abaniel and Richard M. Bergenstal