June 11, 2021
British Columbians living with diabetes will now have the Dexcom G6, a continuous glucose monitor (CGM) that provides regular updates on blood glucose levels throughout the day, covered through BC PharmaCare.
“Thousands of British Columbians will benefit from coverage of continuous glucose monitors, which will allow patients to stay on top of their glucose levels with an easy, convenient system and will help patients and their health-care providers make better treatment decisions,” said Adrian Dix, Minister of Health. “We are grateful for the record number of British Columbians who provided input during our review of continuous glucose monitors. Your input is valuable and helps us determine what coverage is most beneficial to British Columbians.”
CGMs let people living with diabetes take control of their condition by automatically tracking glucose levels in real time. CGMs send regular readings of glucose levels to a device, such as a compatible smartphone or a reader, including push alerts when the patient’s blood glucose levels are outside a defined range. This enables patients or their caregivers to take action sooner, and helps protect people by empowering patients, caregivers and clinicians to identify glucose trends and adjust medications, activity and food intake.
With CGMs, a small sensor is attached to the skin on a patient’s abdomen or upper buttock. The Dexcom G6 sensor lasts 10 days before it must be replaced, and the Dexcom G6 transmitter can be used for 90 days.
These devices are expected to benefit almost 20,000 British Columbians each year in the first three years. At list price, it would have cost approximately $100 million over three years to implement coverage for the Dexcom G6 CGM. The Province successfully negotiated a discount.
The Dexcom G6 CGM will be a limited-coverage benefit, meaning coverage is available to people with diabetes who meet the special authority criteria for CGMs. For patients who receive special authority approval, coverage will be provided to people enrolled in Fair PharmaCare and to those with PharmaCare coverage through Plan C (income assistance), Plan F (children in the At Home program) or Plan W (First Nations health benefits).
On average, over 29,000 people are diagnosed with diabetes every year in British Columbia. Diabetes affects the body’s ability to regulate blood glucose levels. The complications of poorly controlled diabetes range from acute (e.g., fatigue, ketoacidosis and seizures) to chronic (e.g., nerve and organ damage). In Canada, diabetes is the sixth leading cause of death, and the leading cause of blindness, end-stage kidney disease and non-traumatic amputation.
PharmaCare continues to improve access to the medical devices and prescription drugs that British Columbians need. In January 2019, B.C. made a $105-million investment over three years to reduce and/or eliminate Fair PharmaCare deductibles and co-payments for lower-income British Columbians.
Special authority grants coverage to a drug, medical supply or device that otherwise would not be eligible for full coverage. British Columbians are encouraged to register for the income-based Fair PharmaCare drug coverage plan.
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