Continuous Glucose Monitoring Initiative
20th March 2019
By Aus Dept. Health
Expansion of the Continuous Glucose Monitoring (CGM) Initiative
I am writing to advise you of changes to the National Diabetes Services Scheme (NDSS) relating to Continuous Glucose Monitoring (CGM) products subsidised under the scheme. As a result of these changes, more people will now be eligible to access CGM products free of charge.
Expanded Eligibility Criteria for the CGM Initiative
On 25 November 2018, the Minister for Health, the Hon Greg Hunt MP, announced the Government would commit more than $100 million in additional funding to expand the CGM Initiative.
Since 1 April 2017, the Government has provided fully subsidised CGM products to children and young people, under 21 years of age, with type 1 diabetes. From 1 March 2019, the eligibility for this program has expanded to provide fully subsidised CGM products to the following groups of people:
- children and young people with conditions very similar to type 1 diabetes who require insulin;
- women with type 1 diabetes who are actively planning pregnancy, pregnant or immediately post-pregnancy; and
- people with type 1 diabetes aged 21 years or older who have concessional status, and have a high clinical need to access CGM products.
The eligibility criteria for each of the eligible cohorts for this program are detailed on the NDSS website at www.ndss.com.au/cgm. This website also provides access to the application forms used for registering with the scheme. The eligibility criteria were developed in close consultation with clinicians to ensure that access to CGM technology is targeted to those individuals with the highest clinical need. While we appreciate that all people with type 1 diabetes face significant health challenges, it is important that the eligibility criteria for this program are carefully applied to ensure the program can operate within its available budget. To ensure compliance with the eligibility criteria outlined above, we request that health professionals take all reasonable steps to assure themselves that each patient meets all eligibility criteria before certifying their eligibility assessment form. This will support the Government in targeting funding to areas of highest need, through future initiatives.
Accessing Subsidised CGM Products
Patients participating in this program will obtain their fully subsidised CGM products through their local NDSS Access Point, in the same manner as their other NDSS products – such as blood glucose test strips. There are over 5,000 NDSS Access Points across Australia, mostly community pharmacies.
Product Selection and Use
A range of CGM products are available under this program. The selection of an appropriate CGM device is a choice for the authorised health professional in consultation with their patient. While all products subsidised under the scheme have been approved for use in Australia by the Therapeutic Goods Administration (TGA), the indicated uses of these products are not the same. Consequently, health professionals will need to take into account the indicated uses for each product in determining their suitability for individual patients.
The Department has written to impacted health professionals and community pharmacies to advise of the changes to the CGM Initiative. We would appreciate any assistance you can
provide in referencing this information in any relevant communication activities you may be undertaking over the coming months.
The National Diabetes Services Scheme
The NDSS was established in 1987 to provide the subsidised products and services needed for the effective self-management of diabetes. It delivers subsidised syringes and needles, blood glucose test strips, urine ketone test strips and insulin pump consumables to people with diabetes. It also provides fully subsidised CGM products to eligible Australians. In addition to product supply, the NDSS provides educational and information services to assist in the best use of products and self-management of diabetes.
Further information about the CGM Initiative, including the full eligibility criteria, list of available products and application process, is available from the NDSS website at www.ndss.com.au/cgm or by calling the NDSS Helpline on 1300 136 588. Thank you for your assistance in supporting this important health initiative.
Technology Assessment and Access Division
28 February 2019
For more information download this document