CVS Caremark and the Freestyle Libre

Hi, new user here, a quick search didn’t find discussion on this. If I am wrong, please point me to it.

I got a letter from CVS Caremark recently stating that the Freestyle Libre will no longer be covered, that I have to move to Dexcom (didn’t say which Gx version). I am gathering from a cursory read here that people are less pleased with DexCom than the Libre, but I am welcoming opinions on whether I should switch, vs getting my doctor to provide a “no, he needs to keep the Libre” letter and see if they accept that.

It depends on what you want.

I’ve been paying for the Libre out of pocket for several months, also through CVS Caremark, but I want a system that will alert me to lows and offer me the convenience of not having to scan all the time. That can be disruptive if I’m in a meeting. I started looking at MiaoMiao now that I can use it with the 14-day sensors, but my insurance recently approved me for a Dexcom so I’m moving to that instead.

Most people I’ve talked to have preferred the Dexcom, but there are many people here who do not. Research what both options can offer you and decide what’s right for you based on the results.

I’ve used both and the Dexcom is preferred by far, unless they’ve improved the Libre enormously in the last 18 months.

For me it was substantially more accurate. Lots of other reasons. Would never go back.

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The Libre is now a 14-day sensor, and works with iOS and any NFC-enabled Android. Dexcom’s list of supported phones doesn’t support mine, so I would be using their reader (as I am doing now with my Libre)

Thanks for your inputs

I used the Libre for a long time and was happy with it, I would adjust for the inaccuracy etc. Until I wore a Dexcom for a few weeks, it can calibrate and because of that alone is so much better.

I use the reader and my phone, the phone is much better, but not necessary, you just have more programming options with the phone that does make the phone a lot nicer for the alerts. I have the reader in my pocket and it’s just easier to use because I just pull it out and press a button. But I have my phone set for earlier alerts that I am going low or high.

I use the Libre on my dog and the phone ap there is much nicer than the Libre reader too.

When I was paying OOP for sensors the Libre was the best choice financially but when Abbott released the 14 day sensor for the U.S. they blocked those of us who were using a third party transmitter from using those anymore (although the 3rd party manufacturers have recently updated their devices to work in the U.S.). This pretty effectively made the Libre about 50% less useful to me because I could no longer get alarms for out of range BG’s and I couldn’t calibrate the Libre either which was surprisingly detrimental to it’s accuracy for me.

I switched to the Dexcom G6 and haven’t looked back. I test on average once a day and calibrate maybe twice a week although sometimes I don’t calibrate at all. The dexcom like all current CGM systems may not work for everyone but IMO they are the best product currently on the market. If it’s a matter of cost and you are happy with the Libre then by all means go ahead and get your Dr. to try and get it authorized but if you can afford it then the dexcom is considered to be more accurate and the alarms alone make managing diabetes a little bit easier.

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@Wabbit the big question for you is do you need alarms for things like hypo unawareness? If so, the answer is Dexcom or Eversense. If not, then Libre is the cost effective option.

Right now I don’t, my T2 is not that acute and the metformin is supposed to not let it get too low, per my doctor. If anyone has counterinformation on that I would like to hear. So libre if I can keep it, your advice. The question is why CVS/CM would want to drop it in favor of Dexcom, unless perhaps it is making a blanket requirement for your generic diabetic.

Sounds like what @Firenza is saying as well, thanks to you both.

CVS Caremark is the the company that your insurance uses for mail order prescriptions? I can think of two things that might be happening.

  1. CVS doesn’t want to handle Libre anymore because of costs, low profits, returns, complaints etc.
  2. Or your insurance company has decided it doesn’t want to cover Libres anymore, only Dexcoms if you qualify for it when an request by your doctor is submitted.

I have libre 14 day with alarms using xdrip plus and miao2. I admit a little complicated but a cost saver. If you are self employed and or pay cash for your diabetes products this a good option. Dexcom costs 3x the libre and does not last as long. If Abbott adds integrated bluetooth it will be disruptive with pump integration for for icgm. Dexcom is ahead as the only good option at the moment for icgm if you want a out of the box solution and not a DIY.

Wabbit,

I received the same letter, and it also said they were going to cover “DEXCOM CONTINUOUS GLUCOSE MONITORING SYSTEM” instead. However, it doesn’t say which one and the CVS Caremark site also does not list any prices for that same nomenclature as of this writing. I’m researching what will be covered if anything, and which version.

They really could have avoided a lot of frustration in their customers by clearly stating the was/now costs on that letter. I can go on their site and clearly see the was cost. They can’t tell me they don’t know those numbers. I’ve already sent them a message saying as much and requesting clarification. I’ll post back if I find out anything.

In my trade off analysis, I found the DexCom G6 to be inferior to the Freestyle 14 day for various reasons. They just have better marketing. The only thing the G6 does better is it doesn’t need to be scanned. That is of almost no value to me since I can tell if I’m low or high by how I feel. The G6 sensor is bigger, 3.5x the cost, doesn’t last as long (10 days instead of 14), and is supposed to be placed in a much more intrusive location (abdomen instead of back of arm). That just doesn’t work for me. I suspect this move by CVS Caremark is a bet that most people will opt to just pay the retail price for the Freestyle 14 day sensor rather than go with the inferior product they are not covering. That saves them money.

This sounds like another insurance game which we usually play at least once a year, however, the most important thing to find out is your cost. With technology and apps, both products are similar…libre is designed to be less expensive and marketed to the 95% of type 2 diabetics where Dexcom is marketed to the 5% of type 1 diabetics. A lot of the users on the forum have used Dexcom for years and are used to it, but what is important is your cost. My Cigna insurance will cover Dexcom for about $3350 per year after their deduction games, where out of pocket 14 day libres with a miaomiao2 is about $980 per year…not only that, half the users here extend their Dexcom with the same App the libre uses, so checking the cost is tantamount.

I just checked Caremark website, logged in, and clicked on "check drug cost and coverage).

The Freestyle 14-day still seems to be covered at 50% under my plan, seems to be around $300 for 3 months total ($150 for me). The Dexcom G6 miscellaneous (whatever the hell that is… is it sensors? Does it include a reader? It’s not saying) is covered at 83% (I pay 16%), at $220 total ($36 for me). So it seems the G6 is a lot cheaper for my health plan.

Now the abdomen thing is not pleasant sounding, and the fact that the Dexcom is 10 days instead of 14…
Without more info I might just stick to the Libre.

It sounds like you may need to call them to find out the exact costs…the Dexcom still needs the 3 month transmitter and is more often than not under durable medical equipment which means you have to meet your deductible first… mine is 2500, so I’m stuck with the libre and miaomiao2… because libre is marketed as a glucometer or flash glucose, it is pharmacy which is why its cheaper 90% of the time…the alarms are the difference especially if you take insulin or have frequent hypoglycemia

Hmmm…

Very interesting…DexCom is technically way more than you would need. While, in theory, a low blood sugar could happen with metformin, it is very nearly impossible. The price difference between the DexCom and the Libre is huge. (I wonder how big THAT rebate is for CVS to put them as preferred).
DexCom is a bells and whistles continuous glucose sensor whereas Libre (as they are currently) are more of a glorified glucose meter. It looks like it is a CVS wide thing (not just limited to your plan). I’m curious to see what CVS is going to do…I have yet to come across any insurance (or pharmacy benefit manager) that allows DexCom if the person is not using insulin. (So be prepared for the possibility of dealing with that too).

Turns out I misread the letter… they are taking the Libre out of formulary, meaning I pay half instead of 1/6. I can stick with it and pay $25 a pop, $150 for a 3-month supply. Which is what I’m gonna do.

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