Evidence

2024 ADA Standards of Care Recommend Use of CGM Devices Be Considered From the Outset of Diabetes Diagnosis Requiring Insulin Management

January 10, 2024

CGM Technology and Digital Health

Clinical Outcomes

Guidelines / Policy

The ADA Standards of Care include all of of the organization’s current clinical practice recommendations and are intended to provide clinicians, patients, researchers, payers, and others stakeholders with best practices in diabetes management, general treatment goals, and tools to evaluate the quality of care. The recommendations are based on an extensive review of the clinical diabetes literature, supplemented with input from ADA staff and the medical community at large. These comprehensive guidelines are updated annually, or more frequently online if new evidence or regulatory changes merit immediate incorporation In alignment with previous versions of the ADA Standards of Care, the 2024 update highlights the clinical benefit of CGM across a wide range of patient types based on a growing body of evidence.

AMCP Market Insights Health Plan Best Practice: Implementing continuous glucose monitoring to improve patient outcomes in diabetes

January 10, 2024

Coverage and Benefit Design

Article / Publication / CGM Best Practices

Leveraging an opportunity for health plans to support improved patient outcomes in diabetes management with CGM, AMCP sponsored a multifaceted initiative to identify best practices. The program approach consisted of expert interviews, a national payer survey, and an expert panel workshop with clinical experts and managed care stakeholders. In addition to a national webcast to communicate the program findings, this supplement published in the Journal of Managed Care and Specialty Pharmacy summarizes current evidence and consensus recommendations for CGM to support the effective management of diabetes in health plan populations. The supplement also presents the findings from the national payer survey and describes expert-supported health plan best practices around streamlined but evidence-based coverage and access to CGM. Managed care and payer professionals will find this information useful in making collaborative, evidence-based decisions to optimize outcomes among members with diabetes.

Medicaid Coverage

January 10, 2024

Coverage and Benefit Design

Infographic

Updated January 2024

Payer and Health System Experts Share Insights on the Role of CGM in Population Health Management

December 18, 2023

CGM Technology and Digital Health

Article / Publication

While CGM systems were initially prescribed predominantly for patients with T1D, the mounting body of literature and expert recommendations have led to more widespread use in insulin-treated T2D and beyond. Based on RCT and real world evidence supporting CGM use in T2D and published literature demonstrating the utility of CGM in population health, 4 payer and 5 health system experts convened virtually to share their insights on the integration of this technology in current programs. This article provides a review of key evidence discussed by these stakeholders and findings from the meeting, with recommendations for the implementation of T2D population health programs integrating CGM with other interventions.

PayerTalkCE™ Presents: Continuous Glucose Monitoring: Improving Access to CGM Under the Pharmacy Benefit

November 2, 2023

Coverage and Benefit Design

CE Activities

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 0.5 credit hour available for nurses (ANCC), pharmacists (ACPE), and physicians (AMA PRA Category 1 Credit™)

Expiration Date:  April 30, 2025

Educational Objectives
After completing this activity, the participant should be better able to:

• Describe employer/PBM coverage criteria for CGM and the clinical evidence supporting the criteria
• Assess the challenges associated with prior authorization
• Identify opportunities for improved access and reduced administrative burden

Expert Faculty

Janelle Grubbs, RPh

Senior Director of Clinical Services & Operations

Kroger Prescription Plans

Jeffrey Dunn, PharmD, MBA

President and CEO

Cooperative Benefits Group

Jointly provided by Impact Education, LLC, and Medical Education Resources.
This continuing education activity is supported by an independent educational grant from Dexcom, Inc. Medical Affairs.