OBJECTIVES: The management of type I and type II diabetes mellitus (DM) is assisted by blood glucose monitoring utilising blood glucose test strips (BGTS). These technologies are associated with significant expenditure. This study aims to quantify the impact of two health technology management (HTM) strategies implemented by the Health Service Executive-Medicines Management Programme (HSE-MMP), to manage utilisation and reduce expenditure on BGTS in the Irish publically funded health system.

METHODS: Two HTM strategies were implemented to control expenditure on BGTS. Firstly, based on literature review and in conjunction with the National Clinical Programme for Diabetes, a series of automated validations were introduced to the national reimbursement claims software to limit the monthly and annual quantities of BGTS reimbursed for patients, with a separate mechanism to support individuals with additional BGTS requirements.

Secondly, a HSE-MMP ‘Preferred BGTS’ initiative was implemented, where following a review of the clinical and commercial aspects of the marketed BGTS, a preferred list of BGTS was identified. Savings gained through these two initiatives were analysed using data extracted from the HSE-Primary Care Reimbursement Services (HSE-PCRS) national pharmacy claims databases. Data was compiled and analysed in Microsoft Excel™.

RESULTS: Total expenditure on BGTS on the community drug schemes in 2015 was €48.5 million. In April 2016, the automated validations were implemented based on patients’ pharmacological management. This resulted in an immediate reduction in expenditure to €41.7 million in 2017; ongoing expenditure remained at this level (€40.2 million in 2020). The ‘preferred BGTS’ list was published in February 2021. This initiative resulted in a reduction in expenditure to €27.9 million in 2022.

CONCLUSIONS: The implementation of HTM strategies by the HSE-MMP in the area of medical devices has demonstrated reductions in expenditure on BGTS. Similar strategies could be successfully applied to optimise utilisation of continuous glucose monitoring systems.