Posted by: Scott K. Johnson | April 20, 2006 05:10 PM
I'm trying to return mine [Dexcom STS] due to too many false alarms and reading that vary up to 40 points while I'm close to target bg.
It will be interesting to monitor returns.
Here's a blast from your past:
"You should check out the Abbott Navigator which will be approved in the near future."
"I do not work for or receive compensation from Abbott, Minimed or any other DXCM competitor."
It's good that those companies weren't paying you back when you made these statements. Your predictive powers would not be worth the cost.
apologies- correction here is the pump costs $6k-$7k (actually high end is closer to $8k) the year when you buy the new product, it's closer to $1500-$2500 per year every year thereafter assuming you don't buy an upgrade. (based on quick math and assuming changing the insertion set every 2-3 days). I still think it's relevant but didn't want to give bad info as I said in last post that it's $6k-$7k per year.
Thanks for the feedback on the Navigator. I haven't heard the most positive feedback on the comfort of the Navigator and every educator I talk to says they continue to struggle with the FDA (have even heard 07 thrown around by Diabetes professionals - though I know the company has indicated otherwise). I also know that DXCM and MiniMed both surprised the diabetes community with how quickly the STS and 722 were approved so maybe Navigator will as well. If it gets approved and folks indicate that it really is a better product, I will definitely look into it. I do think the minutely readings sound cool. do you have any information on how the insurance proceedings with the pump took place? i imagine they faced the same obstacles about proving long-term efficacy and cost. (the original pump was really just a more sophisticated delivery mechanism that cost $6k-$7k more per year than buying syringes, but insurance companies covered it... and honestly the control impact is no better than what i've gotten out of the STS). Pointless to debate though, we'll just wait and see. I'm filing with my insurance company next week and presenting the charts of before and after STS. I'm sure it's a futile attempt but the results speak for themself so one more person chiming in can't hurt.
Thank you. You should check out the Abbott Navigator which will be approved in the near future. Device is widely acknowledged to have the best accuracy because wired enzyme technology is superior to glucose oxidase technology used in DXCM device. Sensors will have approval for five day use, are waterproof, and readings every minute may help you see trends / excursions more rapidly.
I disagree re reimbursement. Until there is hard evidence that these expensive improve long-term outcomes, in ways that can't be achieved with less expensive technology, payors aren't going to sign up. Reimbursement is going to be a big challenge.
Disclosure: I do not work for or receive compensation from Abbott, Minimed or any other DXCM competitor.
Just my own personal experiences, but my shot at your questions...
1) Shower patches have been fine. Good at protecting the sensor, not a hassle to put on. Of course waterproof would be nice but this hasn't been a real problem.
2) Tough to say how long I'll use the STS since I've only been on it for a week, but for now I intend to keep wearing it and see no reason to stop. Especially with the sensors working for 5-6 days, the cost is worth the benefits. Control is significantly improved and I have gotten used to having the data in my pocket. I disagree with an earlier post that said patients would use the CGM for 2 weeks to find patterns and the stop... I think you will be pressed to find a Type I who says there is much consistency or pattern to his/her Diabetes. There are so many variables that influence blood sugar (carbs, fat in food, exercise, stress, sleep, being in the sun, list goes on) that while the sts has helped me understand how my blood sugar reacts to stimuli, I am still very reliant on data, and doubt that will change.
3) Would I switch products? If something showed much better accuracy then i likely would. That said, I've been positively surprised by the accuracy of the STS. It's not perfect, but I have found it very reliable. If something were just as good but much cheaper of course I'd switch, but I honestly think insurance will cover this product eventually. In my experience, the CGM has been effective at helping control blood sugar levels and trials show it helped patients improve control as well, hence the approval. The alarms help prevent against dangerous (and potentially expensive if hospitalized) low reactions. I can't imagine insurers wont see the benefit of this... better control leads to fewer complications, and complications are what's really costly for insurers. Almost all insurers cover insulin pumps (which cost $6,000 for the device alone, then add insertion sets, batteries, cartridges) and whille my pump is great, I think the CGM is just as incremental in improving control (no data to back this up - just my personal experience).
"Great post. Can you tell me how he has the device before public FDA approval? Make sense of this please or is is otherwise useless."
STS was approved March 27 (See DXCM website) and company began offering for sale a few days later. Post was April 20: AFTER FDA APPROVAL.
I call 'em like I see 'em and report the FACTS, partner, not speculation and unsubstantiated hyperbole. Report away.
I can't wait until the lock up on the huge number of newly registered shares expires on July 26. It's going to be floodin' down in Texas, the sky's going to be cryin', the tears are going to be rolling down your nose, and DXCM is going to be trading a way down south of current prices. Mark it.