Medicare to Cover Insulin Pumps for Beneficiaries

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By: Daniel Trecroci

After years of lobbying and letter writing by endocrinologists and thousands of people with diabetes, Medicare will finally cover insulin pumps for its beneficiaries with type 1 diabetes.

On September 24, the Health Care Finance Administration (HCFA), the agency that oversees Medicare, announced that it will begin funding insulin pumps for people with type 1 diabetes that are covered by Medicare. This includes people over age 65, people with disabilities and people with end-stage renal failure. The coverage policy will not be extended to beneficiaries with type 2 diabetes.

“The American Association of Diabetes Educators (AADE) is extremely pleased that HCFA heeded our recommendation to provide coverage for [Medicare] beneficiaries to have access to insulin pumps,” says David Holtzman, director of governmental affairs for the AADE.

The Medicare decision to fund insulin pumps was based on the fact that diabetes of all types is responsible for $92 billion in direct medical costs and lost productivity each year. According to a Disetronic press release, it has been demonstrated that pump users have significantly fewer complications, like heart and kidney disease, nerve damage or lost vision, than people with diabetes who use syringe therapy.

In a MiniMed news release, chairman and CEO Alfred E. Mann says, “We applaud the action by HCFA to approve coverage of insulin infusion pumps for eligible patients with type 1 diabetes…HCFA’s decision further supports the growing recognition of the effectiveness of insulin pump therapy.”

Animas Corporation, a company trying to enter the insulin pump game, is pleased that Medicare has finally decided to cover pumps, but would also like to see coverage for type 2 patients.

“There is evidence that some patients, by using the pump, are able to break through the insulin sensitivity barrier,” says Audrey Finkelstein, vice president of marketing and clinical affairs at Animas. “Wouldn’t that be great!”

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