Summary of consultation: CGMs, insulin pumps, and consumables

What’s happening?

Pharmac is proposing to fund a range of devices for New Zealanders with type 1 diabetes. 

For many of the 18,000 New Zealanders living with type 1 diabetes, having funded access to continuous glucose monitors (CGMs), insulin pumps, and automated insulin delivery (AID) systems would be life changing. 

Pharmac has now negotiated provisional agreements with the preferred suppliers of CGMs, insulin pumps, and AID systems.

For people currently receiving funded access to the MiniMed 770G insulin pump, this proposal would require a change of their insulin pump. There would be a 12-month transition period from 1 July 2024 to ensure that there is sufficient time to support this change and allow people to consider which of the funded options are right for them.

We need your feedback on our proposal to make sure we get it right.

What we’re proposing 

We’ve used feedback from consumers, clinicians, and other health sector stakeholders, along with clinical advice, to inform our proposal.

From 1 July 2024 we’re proposing: 

• to fund a range of Abbott and Dexcom branded continuous glucose monitors (CGMs) for everyone with type 1 diabetes, which we expect to benefit up to 18,000 people
• to fund the Tandem t:slim X2 brand of insulin pump that can be paired with a funded CGM to create an automated insulin delivery system (also known as hybrid closed-loop)
• to simplify the access criteria for insulin pumps
• to increase the limit of funded packs of insulin pump consumables (including infusion sets, insulin cartridges and insulin reservoirs) to 19 packs per year (an increase from 13 currently).

From 1 October 2024 we’re proposing:

• to delist the currently funded MiniMed 770G insulin pump from the Pharmaceutical Schedule. The associated consumables would be funded until 1 July 2025, allowing people time to consider which of the funded options are right for them.
• to fund the YpsoPump brand of insulin pump compatible with funded CGMs to create an automated insulin delivery system
• to fund an additional Abbott brand of CGM compatible with funded insulin pumps that can be used to create an automated insulin delivery system.

Now we need to hear from you

Your voice will help to inform the final decision we make. We are particularly interested to hear feedback on:

• activities to support current users of the MiniMed 770G insulin pump to move to another funded brand of insulin pump
• what we could do to ensure Māori, Pacific peoples, and those with a disability are supported
• what additional support would be needed to assist patients and health care professionals with this proposal. 

For more details about the proposal, products, implementation considerations and eligibility criteria please see the consultation.

Consultation closes at 4 pm on Friday 26 April and feedback can be emailed to consult@pharmac.govt.nz

What happens after the consultation?

Pharmac will carefully consider all pieces of consultation feedback and make any necessary changes to the funding proposal. 

The Pharmac Board will then consider all consultation feedback, along with the proposal, and decide on the outcome.

When the decision is made, Pharmac will notify the public and health sector of the outcome. If approved, Pharmac will work with the health sector and the community to make sure that people who want to use CGMs, insulin pumps, and automated insulin delivery (AID) systems can do so.

The final funding decision will depend on the feedback we receive and consideration of our fixed budget.

About the devices included in this proposal

About continuous glucose monitors (CGMs)

CGMs measure interstitial sugar levels (the sugar levels in the fluid between cells) which are a good estimate for a person’s blood sugar levels. CGMs allow people with type 1 diabetes to avoid the pain and anxiety associated with regular finger-prick testing.

CGMs have two main parts: a sensor, which sits just underneath the skin, and a transmitter which sends information to a device (such as a smartphone, tablet, or reader device) every few minutes. Some CGMs also allow a user’s clinicians, carers, family, or friends to “follow” these readings, which can help with diabetes management.

About insulin pumps

Insulin pumps are medical devices that continuously deliver a baseline level of insulin. They are an alternative to manually injecting insulin multiple times a day. They also allow for bolus doses of insulin to be delivered when eating. Insulin pumps are made up of: 

• the pump;
• a disposable reservoir to store insulin; and
• a disposable infusion set, which connects the pump to a cannula inserted underneath the skin. 

About Automated Insulin Delivery (AID) systems

AID systems have three parts: an insulin pump, a CGM, and the software or algorithm that allows the insulin pump and CGM to communicate with each other. The algorithm uses the readings from the CGM to increase the insulin dose if blood sugar levels rise too high and to reduce the insulin dose or temporarily pause insulin delivery if blood sugar levels drop too low.

The two proposed options have different features, people can discuss these with their diabetes team to get the best clinical benefit.