Pharmacy Pearls: Continuous Glucose Monitoring

Pharmacy Pearls: Continuous Glucose Monitoring

July 30th, 2021 | Pharmacy PearlsDiabetes

This edition of Pharmacy Pearls provides an overview of continuous glucose monitoring systems (CGMs), including:

  • patient populations where the use of CGMs may be beneficial based on recommendations in the 2021 ADA Standards of Medical Care in Diabetes
  • comparison of characteristics of the Dexcom G6 system, Freestyle Libre 14-day Flash, and Freestyle Libre 2
  • an important CGMs patient counseling point to remember
  • quick review of coverage for patients with Excellus Commercial or Medicare pharmacy benefits

For patients with Excellus Commercial or Medicare Advantage Pharmacy Benefits, please consider preferentially sending new or refill prescriptions for CGMs — sensors, transmitters and receivers — to the pharmacy rather than medical supply retailer. Excellus commercial plans now use smart logic during adjudication at the pharmacy that searches for approval criteria (appropriate age and history of insulin use) reducing the need for prior authorizations and paper work. Excellus Medicare Advantage plans will still require prior authorization, but patients are likely to benefit from the convenience of having CGMs filled at a pharmacy with other medications and may see reductions in their out of pocket costs Please email the Pharmacy Team for a list of patients that may qualify for fills at a retail pharmacy.

As always, we welcome any questions or feedback you may have.  Just email the Pharmacy Team.

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