In their quest to better care for people with diabetes, medical device manufacturers are innovating a lot – in terms of price.

Medtronic offers to pay up to $ 25,000 if patients use their most advanced insulin pump at the hospital. Abbott Laboratories has launched its latest continuous glucose monitor at prices designed to be low enough to promote rapid global adoption. More drastically, Bigfoot Biomedical plans to offer its upcoming insulin devices for a monthly subscription fee instead of an initial amount of thousands of dollars.

The changes are motivated by the realization that the traditional model of med-tech pricing, and then charge more for it – could compromise the latest technical innovations. Diabetes may be already the most expensive chronic disease in America, but that does not mean that insurers will attack it by paying for more expensive devices.

"Diabetes is a huge cost factor for insurers," said Russ Montgomery, vice president of the consulting firm Discern Health, who studied value-based pricing in appliances. new technologies are more expensive, that goes against that. Thus, they [insurers] try to extract as much value as possible. "

Medtronic has announced in recent weeks a program that would pay up to $ 25,000 to insurers who use the company's most sophisticated insulin pump, the MiniMed .670G, are hospitalized for problems This announcement follows news from UnitedHealthcare, a Minnetonka-based insurer, that Medtronic insulin pumps reduce hospitalizations among members during the first year of a four-year study.

Abbott Laboratories – another major supplier of devices in the diabetes market in Minnesota – has recently unveiled a low-cost disposable device that can continuously measure glucose without a stick.The device, called FreeStyle Free , has been deployed with a focus on pricing by immediately releasing it with a cash payment option and similar pricing around the world.

ix is ​​immediately evaluated from the start. … The product's goal is really about one thing, and it's access, "said Vicky Assardo, spokesperson for the Abbott Labs Diabetes Division. "It's not really innovative if people do not have access to it."

Bigfoot Biomedical of California is developing a subscription model for its insulin management devices that appears to be unique in the industry.

and testing the key components of its technology, the company has already announced that insurers and / or patients will be able to pay for it under a monthly subscription. According to Bigfoot CEO, Jeffrey Brewer, monthly prices could even change depending on the patient's results, like staying out of the hospital or achieving measurable goals in insulin management.

. Durable Bigfoot components without any risk of wasting money spent from the purchase of the device, he said. (The company is seeking permission from the US Food and Drug Administration to sell its automated pump delivery system and its insulin injection system by 2020).

In each case, medical device manufacturers new ways to overcome the same hurdle, namely that high initial prices compromise the ability of insulin management to create long-term benefits for health, even when the potential value of the technology is demonstrated in clinical studies. model of innovation, we would not be able to deliver technological innovation, "said Brewer." There is such prejudice against new things that entail costs to the system, because most time, they did not work, they simply add cost. "

Payers look at diabetes with caution. The problem of blood sugar is a growing public health problem, accounting for $ 237 billion last year in direct health care spending in the United States. About 29 million Americans have one of the forms of the disease, of which 24.7 million are diagnosed. According to the World Health Organization, approximately 422 million people worldwide had diabetes worldwide in 2008.

Analysts at Grand View Research believe that the global market for diabetes management devices Insulin will grow at 7% per year and exceed $ 35 billion in annual sales by 2024.

Insulin is a natural hormone that allows the body to extract blood. energy of sugars in the bloodstream. When the body does not produce enough insulin or does not use insulin efficiently that it produces, high blood sugar ("hyperglycemia") can cause problems to long term like nerve damage, increased risk of stroke and kidney disease. Very high blood sugars can lead to acute problems requiring a trip to the hospital.

Injecting too much insulin is also bad – it lowers blood sugar levels too low ("hypoglycemia") and can trigger problems with irregular heartbeat. medical devices for insulin management aim to give users the ability to accurately administer the right amount of insulin, whether through manual injections calculated from glucose meters or sensor readings or by small electronic pumps worn on the body that can communicate with a continuous glucose monitor.

The American Diabetes Association has stated that continuous glucose monitors can be a useful tool for lowering average blood glucose levels in patients with type 1 diabetes. Efficacy has yet to be determined.

Company-led studies tend to show that patients stay healthier when they become more frequent. information about their blood glucose readings in real time. Abbott unveiled study results last month that showed people who used its continuous blood glucose meters had an average reduction of 0.56 point from a measurement called A1C, which examines glucose control over time. of time and spent $ 120 a month less than

Medtronic and UnitedHealthcare reported that members using Medtronic insulin pumps from 2016 to 2017 had 27% fewer hospitalizations than members who did not use these pumps.

This kind of statistics is especially important for devices with higher initial price tags, such as advanced insulin pumps, that can contribute to long-term health benefits, even if patients change their moods. insurer every year.

"If an insurance company makes an investment, I think there are benefits for them in the short term," said Suzanne Winter, director of Medtronic's Diabetes Division. that we want patients to do, and what we want insurance companies to do, is to invest early enough in the patient's life to get the benefits of reducing the complications that can occur 10 to 15 years later "

[19659024]