Tuesday, 25 June 2013

Costly business

Paying for your health care, be that in the form of medical insurance or prescriptions, right the way up to paying for every single hypodermic needle, and whether that's 'right' or 'wrong' is of a matter of personal opinion and can start many a heated debate - particularly in a culture where most of our care comes free.  

We hear horror stories all too often about our friends in the US left lying on hospital gurney's while their families scrabble around for money for care, or children in India who in 2013 continue to die because they cannot afford insulin.  So how do I feel about paying for my own care?  Well, as someone who is fully funded for everything else that I need, other than Continuous Glucose Monitoring (CGM), I can live with paying for something here and there.  My view is that if I value my CGM enough, I will pay.  But CGM is an expensive business; disgustingly expensive, in fact.  

Priced at £62.50 per sensor (plus p&p) and with each sensor lasting only 7 days (how long it has CE mark approval for) to use it continuously would cost  - and I suggest you sit down for this - £3250 per year to fund (not including the initial outlay of £975 for the stand alone unit).  You still there?  Not fainted yet? 

Seeing as I don't spin gold or sweat pound coins, I simply can't afford that kind of money.  Show me many who could.

As a result I have had to find ways to make my sensors, or my money, last a little longer.  Over the last few months I have discovered little ways to make the cost a little more affordable for me.  So here are my Top 5 experiences of getting a little more out of the system.  

Please remember that I am NOT a diabetes professional, medical or otherwise, I DO NOT speak for Dexcom, Animas or Advanced Therapeutics and I am NOT suggesting anyone do as I do.  Now that the legal bit is done and no-one can sue my rear end, here is how I do it:

1) Consider sensor sourcing.  Until recently I purchased my sensors from a fantastic company called Advanced Therapeutics.  Fast, friendly and professional, they offer a great service.  But they aren't the only provider of G4 sensors in the UK.  Animas, with the introduction of the Vibe insulin pump, also sell the sensors.  I had believed that to buy from them I would need to be on a Vibe pump (which I'm not).  But after a recent conversation with them I discovered you can register as a private customer and buy sensors from them.  Cheaper.  My previous costs were approximately £135 for 2 sensors plus postage and packing at £7.50 per delivery.  Not only do Animas only charge £100 for 2 sensors, there is no p&p.  SOLD.  To register with them, you need a letter from your team to state that your data is reviewed in clinic and to complete their VAT exemption for.  Contact animasUK@its.jnj.com for more info.


2) I wear my sensors for longer than I should.  I do NOT recommend anyone do this as it is against the guidance from the company, but if you do then hey, that's your choice.  I wear my sensors for as long as they will go for or if they feel uncomfortable at all (not happened yet), which has so far varied between 8 and 36 days. When it comes to the system warning me that the sensor is expiring I simply restart, telling the system I have inserted a new sensor, when in fact it is the same one.  Boom.  Money saved. Mwahahahaha !

3)  Wearing my sensor on my arm.  It is fast becoming the industry's worst-kept secret that wearing the sensor on the arm seems to make it last longer.  I don't know if this is because the arm is less jiggly (I got a lotta jiggle) or some other mystical force but for me, arm sensors go significantly longer than others.  The one I removed this morning was 36 days making the cost go from almost £9 per day, to £1.70 (or £1.40 on the Animas sensors).  Granted it is a reasonably rare occasion to get this long, but my last 4 sensors have all done between 22 and 36 days.  So they are consistently in the 3 week onwards time length.

4) Give it a rub.  Oo er.  This one comes from everyone's favourite German blog's Ilka, who told me that when she gets the ??? symbol, she massages the site for a minute or so, making it last longer.  I wasn't convinced, but gave it a try and every single time my struggling sensor has fired itself up again.  Give it a try, does it work for you?

5) Get a Vibe insulin pump.  In the UK you apply for a new funded pump every 4  years - as the warranty runs out.  The Vibe insulin pump has integrated Dexcom CGM, meaning you don't need the standalone unit (£975 of your best pounds). That starter kit includes the unit and the software etc, but no sensors (seriously, a starter kit with no sensors?) so to get started you need £975 plus £250 for 4 sensors and £7.50 p%p.  That's £1232, if you were wondering.  However, If you order the starter kit that integrates into the Vibe pump, rather than the stand alone unit, it costs £450 from Animas, including 4  sensors.  That's right, 1/3 of the cost over the standalone unit and you can get started straight away, saving the cost of 16 sensors while you are at it. Maybe when you are due to review, this pump would be worth a look.

So there you have it.  No, I haven't figured out how to make this cheap.  Yes, it continues to be a shockingly expensive tool, but that doesn't mean it isn't worth it; it is worth it.  And hopefully this post has given you something to think about if you are considering CGM sometime in the future or are using it and looking for ways to cut the costs a little.

Big love, as always.


  1. Hi Anne,

    I am wondering how much people would pay out-of-picket, for a one-time upfront cost of a noninvasive (optical) glucose sensor with minimal recurring costs for things like battery and cleaning equipment.

    It would love to survey your readers for this answer.

    -- A technologist in noninvasive.

    1. Please excuse the obvious typos...

    2. Hi,

      Thanks for posting. I'm not sure if you saw the post about C8 Medisensors last year, but this is the link, in case it is of interest. http://insulinindependent.blogspot.co.uk/search/label/C8%20Medisensors

      C8 are/were working on a non-invasive, optical CGMs and for a while we were extremely excited about it. The mumblings were that the unit would be costed between £2500 and £3000 and people seemed prepared to pay that.

      For me there were 2 issues.

      Firstly - size. The unit we were shown was very bulky. At first I thought I would be able to manage for the benefit of CGM, but having got invasive CGM, I know that having it fit into my life with only one, small sensor, is very important to me. If you are slim, the profile of the system would have been obvious under clothes. Not to mention it gets warm when being used. I can't imagine hot summers with a large, warm, sweaty device attached.

      Secondly, the data was a little unclear about the error rates and I don't have the company's permission to share what we were shown, but the current invasive systems appear more accurate.

      I believe people would pay a lot if the system was comparable to the reliability and accuracy of those on the market - particularly those with children who want CGM but struggle with the many poke, prods and pricks they have to submit their little ones to. But I am not sure the version we saw was quite there.

      I would be very interested in sharing this with my readers and would happily use my Twitter and FB accounts to spread the word and get more.

      Is there any more you can share about what you are working on/looking into? ie are you using the current Raman Spectroscopy technology, or are you working om something else?

      I would be very interested in hearing from you so if you would like to know more.

      You can email me on insulin.independent@gmail.com

      Best wishes


  2. Hi Anna - I know your article is a year old now but having recently self funded a G4 I've found it really informative and helpful - so thanks! I've just contacted Animas (using the email address you give above) but have been told only Vibe pump users can buy sensors from them (I have a Roche pump and don't want a Vibe). This is really disappointing and I wondered if you'd heard that Animas have changed their rules since you wrote this article? I'm now wondering if there are any Vibe users in my area that would be prepared to buy extra sensors from Animas and let me buy them off them - could be a lot of hassle but it's potentially a big cost saving.