Funding CGMs: How we got here

From 1 October 2024, continuous glucose monitors (CGMs) will be funded and available to those with type 1 diabetes, alongside new arrangements for funded insulin pumps and consumables.

But getting to this point was complex. The process of funding CGMs alongside insulin pumps involved innovation, commercial processes, collaboration, and the input of the wider health and disability system to make sure we understood the needs of consumers, clinicians, advocacy groups, and whānau. 

“People living with type 1 diabetes, their whānau and the healthcare sector told us that CGMs and insulin pumps would make a real difference,” says Pharmac’s Director of Pharmaceuticals Geraldine MacGibbon. “We had wanted to fund them for some time.”

The commercial process began in February 2023 when Pharmac gave notice of a Future Procurement Opportunity (FPO) to suppliers. In July 2023, Pharmac invited proposals from suppliers through a Request for Proposals (RFP). 

“The RFP process is often complex. We’re not just looking at one product or one person’s situation. This is especially true for CGMs and insulin pumps, and it took time to carefully assess bids, identify the best options, and consider proposed brands, access criteria, and implementation plans,” says MacGibbon. “We worked closely with our stakeholders to help us better understand what would work for people with type 1 diabetes – especially the usability and suitability of the different devices.”

Pharmac then developed a proposal to fund CGMs alongside insulin pumps and insulin pump consumables and asked the public – with focus on those who would be impacted by this decision – to give their feedback. 

“During the consultation, Pharmac received a lot of feedback,” says MacGibbon. “While most of this feedback supported the proposal, parts of it indicated that we needed to do further engagement with clinicians, consumer groups, and suppliers, to better understand the impact of our potential funding choices. 

“It was imperative that we got this right. So, in May 2024, we pushed back the timeline for putting a funding proposal before Pharmac’s Board. We’re glad we made that call. It meant we could be sure that we had the right information so that our proposal to the Board was as robust as possible.”

Throughout June and July, Pharmac staff met with a large range of people to discuss the feedback. This included the Diabetes Advisory Committee, Diabetes NZ, the New Zealand Society for the Study of Diabetes, Health New Zealand and other government agencies, as well as suppliers.

“We were more innovative in how we engaged,” says MacGibbon. “It was important that people heard from us directly about the rationale for delaying the decision and the information we needed to progress. We wanted to reach people more deliberately and effectively than before. These strategies – and the feedback we received through these channels – certainly had an impact on the final proposal.” 

“The new methods and technology we used, such as online town halls where people could ask Pharmac questions directly, was very successful,” says MacGibbon. “In the future, we hope to use these strategies more often, including in future commercial processes and in our Hospital Medical Devices programme work.”

In August, Pharmac staff presented the updated proposal, including the feedback and amendments made, to the Pharmac Board. It was confirmed that CGMs and insulin pumps would be funded.

“This was a huge moment. Our team was elated as we knew this decision would make a meaningful difference to people with type 1 diabetes. It felt great to see the announcement go out on 29 August. It was the culmination of a lot of work, not just by Pharmac staff, but by clinicians, consumer groups, and all those who supported and advocated for the decision,” says MacGibbon. 

“We are very pleased with the outcome and look forward to 1 October, when the benefits to New Zealanders living with type 1 diabetes will be realised.”