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Pediatr Diabetes. 2019 Jun;20(4):434-443. doi: 10.1111/pedi.12833. Epub 2019 Apr 11.

Persistent heterogeneity in diabetes technology reimbursement for children with type 1 diabetes: The SWEET perspective.

Author information

1
Department of Pediatrics, Motol University Hospital, Prague, Czech Republic.
2
Department of Pediatrics, Medical University of Warsaw, Warsaw, Poland.
3
Department of Pediatrics, Medical University-Varna, UMHAT "Sv. Marina", Varna, Bulgaria.
4
Department of Endocrinology, Diabetes and Metabolism, UMC, University Children's Hospital, Ljubljana, Slovenia.
5
Department of Women's and Children's Health, Azienda Ospedaliero-Universitaria, Ospedali Riuniti di Ancona, "G. Salesi" Hospital, Ancona, Italy.
6
Institute for Clinical Sciences, Dept of Ped, University of Gothenburg and the Queen Silvia Children's Hospital, Sahlgrenska Univ. Hospital, Gothenburg, Sweden.
7
Department of Pediatrics, KLE University's Jawaharlal Nehru Medical College Belgaum, Belgaum, India.
8
APDP-Diabetes Portugal and Nova Medical School, Lisbon, Portugal.
9
Department of Pediatrics, University Hospital Center "Sestre milosrdnice", School of Dental Medicine, University of Zagreb, Zagreb, Croatia.
10
Department of Pediatrics, Diabetes Center, P & A Kyriakou Children's Hospital, Athens, Greece.
11
Diabeter, Rotterdam, The Netherlands.
12
Department of Medical Psychology, Hannover Medical School, Hannover, Germany.

Abstract

BACKGROUND:

Frequent use of modern diabetes technologies increases the chance for optimal type 1 diabetes (T1D) control. Limited reimbursement influences the access of patients with T1D to these modalities and could worsen their prognosis. We aimed to describe the situation of reimbursement for insulins, glucometers, insulin pumps (CSII) and continuous glucose monitoring (CGM) for children with T1D in European countries participating in the SWEET Project and to compare data from EU countries with data from our previous study in 2009.

METHODS:

The study was conducted between March 2017 and August 2017. First, we approached diabetes technology companies with a survey to map the reimbursement of insulins and diabetic devices. The data collected from these companies were then validated by members of the SWEET consortium.

RESULTS:

We collected data from 29 European countries, whereas all types of insulins are mostly fully covered, heterogeneity was observed regarding the reimbursement of strips for glucometers (from 90 strips/month to no limit). CSII is readily available in 20 of 29 countries. Seven countries reported significant quota issues or obstacles for CSII prescription, and two countries had no CSII reimbursement. CGM is at least partially reimbursed in 17 of 29 countries. The comparison with the 2009 study showed an increasing availability of CSII and CGM across the EU.

CONCLUSIONS:

Although innovative diabetes technology is available, a large proportion of children with T1D still do not benefit from it due to its limited reimbursement.

KEYWORDS:

children; diabetes technology; reimbursement; type 1 diabetes

PMID:
30773756
DOI:
10.1111/pedi.12833
[Indexed for MEDLINE]

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