Glucose management devices have undergone rapid technological advancement since their initial approval and have had meaningful changes in coverage over the past decade. These changes correspond with significant increases in utilization among Medicare fee-for-service (FFS) beneficiaries with Type 1 diabetes (T1D), highlighting the impact of treatment coverage to patient access. T1D affects 1.7 million adults aged 20 years or older in the United States, accounting for 5.7% of all U.S. adults with diagnosed diabetes. In response to changing diabetes prevalence rates and improved device technologies, the Centers for Medicare and Medicaid Services (CMS) has updated coverage policies for devices over the past decade. Analyzing claims from calendar years 2014 to 2023, this paper offers a longitudinal analysis of device utilization in the context of changes over time.

Takeaways

• Driven by use of continuous glucose monitors (CGMs), Medicare FFS beneficiaries with T1D have increasingly used devices over the past decade, reaching 77.4% in 2023, up from 19.7% in 2014.
• The share of beneficiaries using CGMs for at least 180 days per year first exceeded 50% in 2018, illustrating how expanded coverage of devices aligns with improved rates of consistent use.
• By adopting coverage of CGMs for Medicare beneficiaries, CMS has improved beneficiaries’ ability to follow current clinical standards of care and increased the likelihood of positive health outcomes in managing their diabetes.

This report was commissioned by Breakthrough T1D.