I propose to take Questions Nos. 278 and 279 together.
Continuous glucose monitoring (CGM) systems provide an alternative approach to self-monitoring of blood glucose (using blood glucose test strips with an associated blood glucose meter). These CGM systems comprise of sensors, transmitters and a mechanism to display the results (readers/receivers or smart device application).
Under the Health Act, 2007, the Health Information and Quality Authority (HIQA) has a statutory remit to evaluate the clinical and cost effectiveness of health technologies and provide advice to the Minister for Health. HIQA conducts Health Technology Assessments (HTA) for programmes and services at the specific request of the HSE/DOH, which may include medical devices.
The HSE has advised that the HIQA Rapid HTA of Continuous Glucose Monitoring in Adults with Type 1 Diabetes Mellitus was published on 29th September 2023.
The HTA recommended the establishment of a single managed access programme for all CGM systems for all individuals with type 1 diabetes mellitus regardless of age, noting that such a system would need clearly defined criteria for access. Following on from the recommendations in this HTA, the HSE-MMP, in conjunction with the HSE-PCRS, and with the support of the HSE Chief Clinical Officer, introduced an online reimbursement application system for all CGM sensors on 1st December 2023.
Reimbursement support for CGM sensors at this point in time is based on the HIQA HTA and is for patients with type 1 diabetes mellitus regardless of age, who have required insulin from the outset.
To date, a HTA of CGM sensors for people with type 2 diabetes mellitus or other types of diabetes has not been undertaken in Ireland. Therefore, there is limited information to support the extension of reimbursement to these patient groups, including cost-effectiveness assessment and budget impact of same.
The HSE has identified preferred CGM products based on cost-effectiveness to manage this expenditure. A second review of CGMs is taking place which will include an update of the preferred CGM sensors evaluation.
On the 21st of May, The Diabetes Policy and Services Review: A Strategy for Better Care was launched by the Minister for Health.
This is Ireland’s first national strategy for diabetes. It sets out recommendations for action in relation to type 1 diabetes, type 2 diabetes, diabetes in pregnancy and paediatric diabetes. The strategy marks a major milestone in diabetes care in Ireland, representing the development of a unified approach to the delivery of diabetes care.
