New Medicare Competitive Acquisition Program Could Hurt Patients With Diabetes

Medicare beneficiaries with diabetes may be adversely affected if blood glucose monitors and related testing supplies are included in Medicare’s competitive acquisition program expected to start in 2007.

According to a survey released last week by the National Association of Chain Drug Stores, conducted by Health Policy R&D, examined several clinical, technical and patient access issues relating to chronic management of blood glucose levels in patients with diabetes.

Self-monitoring of blood glucose levels with glucose monitors is an integral part of disease management for patients with diabetes. These products are covered under the durable medical equipment benefit in Medicare Part B and could potentially be available only from suppliers approved by the Centers for Medicare and Medicaid Services under the new competitive bidding program.

According to the survey, a competitive acquisition program that includes glucose monitors and supplies could create a situation where Medicare beneficiaries with diabetes might be unable to access all aspects of their glucose management regimen— including their medications, monitors, supplies and related professional services—from their community pharmacy of choice.
Mary Ann Wagner, senior vice president of policy, pharmacy and regulatory affairs for NACDS, said the findings should raise some red flags for Medicare administrators.

“CMS needs to be aware that competitive bidding for blood glucose meters and related supplies under Medicare Part B could potentially do more harm than good for beneficiaries by denying access to their community pharmacist.” Wagner said.
Currently, Medicare beneficiaries can choose from many different types of monitors with different features that work best for their individual needs. The study indicates that a competitive acquisition program may not ensure that patients are matched with the most appropriate equipment and supplies to meet their needs.

The study also found that failing to control glucose levels is significantly more costly than the expenses of glucose meters and related supplies. Mismanaged care for diabetes patients and the failure to achieve good management of patients’ glucose levels could result in sizable healthcare expenditures that are borne by the Medicare program and other health insurance plans, the report stated.

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