Presentation (CTI)

OBJECTIVES: Continuous glucose monitoring (CGM) systems provide an alternative approach to self-monitoring of blood glucose. From 2021 to 2023, Ireland’s payer, the Health Service Executive (HSE), experienced a significant increase in expenditure on CGM sensors, from €23.78 million in 2021 (6,000 patients) to €55.72 million in 2023 (16,900 patients). Following a rapid health technology assessment (HTA) on the use of CGM systems in adults with type 1 diabetes (T1DM), an online reimbursement application system (RAS) for CGM sensors was introduced on 1 December 2023. This study evaluates the impact of the RAS as a cost containment measure for CGM sensors during its first year of implementation.
METHODS: Data pertaining to individual reimbursement applications was extracted from the online RAS from 1 December 2023 and 30 November 2024. Utilisation and expenditure data were extracted from the national pharmacy claims database. Data was compiled and analysed in Microsoft Excel™.
RESULTS: A total of 4,552 applications were submitted for reimbursement approval. The overall approval rate was 65% (n=2,949), which represents an additional investment of approximately €9 million across the first full year of reimbursement support for eligible patients with T1DM. The avoided costs estimated from negative reimbursement recommendations amount to over €1.77 million. This estimate is based only on applications submitted via the RAS and the true avoided cost is likely much higher.
CONCLUSIONS: In its first year of implementation, the RAS has supported almost 3,000 additional patients with T1DM to access CGM sensor technology, whilst containing expenditure and providing budgetary oversight for the payer.