Dexcom Delays Medicare Coverage of G6


#1

I talked the my Dexcom Area Rep this morning, and he told me that Dexcom will NOT be covering the G6 on Medicare in April as previously announced. He said that they have pushed the G6 coverage on Medicare back to a “date to be announced” status. Since Dexcom is starting to be unreliable, since they are letting go their American sales and customer service people (including the man I talked to this morning), and since I now might have to pay out-of-pocket for the G6, I am seriously thinking of just quitting using a CGM totally. All of this hassle and cost hardly seems worth what I am getting out of the CGM.


#2

I don’t get it. Medicare is covering the G5 in the same manner they will be covering the G6. Costs are not going to be any different so why don’t you just continue on the G5 until the G6 becomes available?


#3

While that makes sense given the apparent turmoil going on over at Dexcom, this also is extremely shady given that Dexcom just announced on its earnings call (Feb 22):

Steve Pacelli, Dexcom EVP, Strategy & Corporate Development:

The continued roll-out of G6 remains a primary strategic priority for DexCom at the outset of 2019. In the U.S., we plan to begin shifting G6 to our Medicare patients in the near-term and we have multiple U.S. introductions planned for the balance of the year.

If Dexcom announces “near-term” G6 to Medicare patients on an earnings call and one week later has a significant change of plans, they (Dexcom) really should provide an official update (ie - company Press Release).

To fail to do so carries significant issues around one’s ability to trust what Dexcom says.


#4

I have been hearing that there will be a cure for diabetes in the near term for past 30 years. I think “near-term” is in the eye of the beholder depending which side of the fence you are on in this business.


#5

Sure. Somebody with no honor can spin anything they like.

And I will treat their future statements accordingly.

Dexcom can pound its reputation into the ground if that is what they want to do.

It is disappointing but I will get over it.


#6

I have never been on the G5. I started the G6 in May 2018 with the idea that when I got to Medicare age (starting today), that the G6 would be covered by Medicare. My rep told me I could go back to the G5, but why would I want to go backwards? I am used to the G6, and I like some of the features, so the G5 is not an option.


#7

I agree! That is why I am contemplating just quitting the G6 and Dexcom all together.


#8

Got you beat! I have been hearing the cure for diabetes will be in the next decade… and that has been for the last 50 years!


#9

We will not quit using them. The technology is still the best choice in our situation.

I no longer hold my previous high opinion of the company and the Executive Leadership team. It is what it is.


#10

If you can keep your A1C where you are comfortable with or without a CGM, then sure may as well call it quits with Dexcom. As far as going backwards, I am not convinced that would be the case. Many of us on the Medicare G5 are going to hold off as long as we can because we are not convinced that the current G6 is a better option and who knows G7 may come out earlier than predicted. Dexcom got medicare approval earlier than they expected which is what has caused a great portion of their and our misery. For me quitting Dexcom until G6 or G7 becomes available to Medicare would be cutting off my nose to spite the face.


#11

I did not mean to imply that the G5 was not a good system. It is just older, and as Dexcom looks forward to the G7, I would not be surprised if they contemplate phasing out the G4 and the G5 before they would phase out the G6. Last week Canada approved the Dexcom use for their country, so Dexcom announced that it “very soon” will start a world-wide release of the G6 to Canada and other countries of the world. They can plan to ship to other countries, but they do not seem to want to take care of their US Medicare patients. And, of course, we Americans pay the highest drug cost prices in the world. My theory is that Dexcom actually gets less money for the system from Medicare than it would if selling it outright to younger diabetics with corporate insurance, so why bother with a lower-paying population? Never fear that Dexcom has one very obvious motivating factor: money.


#12

I’ve been using Dexcom CGM systems since 2009. I currently use the G4 system due to its better radio range and longer transmitter life than the G5 or G6 units. I had briefly upgraded to the G5 a few years ago but I didn’t like the less robust radio connection and the subsequent loss of data points. The thing that really bugged me about the G5 was its insanely bright white background display when viewing during the night.

So I happily dropped back to the G4. While I’ve been on Medicare for a few years, I had a former employer supplied insurance that covered the G4. With Dexcom’s announced intention to start supplying the G6 in April 2019 to the Medicare population, I decided to drop that former employer supplied insurance and replace it with the standard Medicare supplemental policy on January 1, 2019.

I knew I was taking a risk with my insurance coverage decision but my fall-back plan is still acceptable to me. Once my G4 supplies dwindle a bit, I will place an order for the G5 and wait for the G6 upgrade, whenever that happens.


#13

Your theory is a fact as specifically stated by Dexcom CEO:

With respect to pricing in the U.S., as Quentin often says, pricing by channel for us has remained relatively consistent, but as we move more business into other channels, for example the pharmacy channel and currently the Medicare channel has lower price than we recognized in the past. We’re preparing as we talked in our Analyst Day over the long-term to be a viable competitor in the pricing environment whatever it turns out to be.


#14

The first iteration of the G5 transmitter would indeed lose data points during breaks in communications. The G5 transmitter was updated after initial release such that all current G5 transmitters (G6 continues this enhancement) have a 3-hour backfill capability. The current G5 transmitter stores the last 3 hours of cgm data points on the transmitter itself. With a receiving device (whether it be Dexcom Receiver, Pump, App on SmartPhone) which is also compatible with the G5/G6 Transmitter Backfill capability, the data will show up upon resumption of communications to a max of 3 hours into the past.


#15

I wasn’t aware of this and it’s good news for me.

Listening to recent podcast interviews with Dexcom technology officer, Jake Leach, i heard him say that the G6 Follow app, under update, but not yet released, has addressed the “too bright at night” display. Nice to see them respond to observations made by users like me. I wonder if they’ve changed any display brightness attributes on the main G6 receiver app.


#16

I started with Dexcom Seven+, upgraded to G4,G5 and now G6. I’ve really never had an issue with Dexcom or any of their upgrades. My biggest issue is with their mobile app features. But overall it a premium product. There are a lot of things in my life i would give up before giving up my dexcom.

I read all this stuff people say about Dexcom and I can’t relate or really understand. But it makes for an interesting read.


#17

Same for us.

Absolutely.

I appreciate what the Dexcom management team has done and provided for us in the past. I hate to be an a$$ about it. But the past is not good enough for me. I also want the future.

I am a big rah rah fan of Dexcom but if management screws up, then they need to know it. Hopefully they will make a course correction.


#18

@Terry4. FYI late night I was on the Dexcom website in the FAQ/Medicare section and saw the following the following that seems to indicate the April 2019 date has slipped to Q4 of 2019 and now is in writting.

From the Dexcom website FAQ/Medicare section:

I am a current Medicare customer using Dexcom G5 Mobile - how do I upgrade to G6?

When we begin shipping Dexcom G6 in Q4 2019, existing customers will be automatically upgraded to G6 when they are out of warranty on their Dexcom G5 transmitter. Customers do not need to do anything currently. Dexcom will be checking their eligibility at the monthly check in.


#19

Good catch. Your reference is the first I’ve seen that links to a Dexcom written source. I don’t get why this has not been communicated more proactively and plainly to the Dexcom Medicare community. As I’ve written above, many of us need to coordinate supplies and insurance coverage to dovetail with the G6’s availability to Medicare recipients.

This communication style is needlessly cryptic. Dexcom has a large bank of goodwill built up with me, but this definitely subtracts from that balance. My sense of goodwill toward the company has its limits and if an equivalent product were available from a competitor, I might be less patient.


#20

Actually, your rep said you could go back to the G5, so it IS an option; you just refuse to take it. So you are so angry you will just quit using a CGM, eh? Wow, I guess a CGM doesn’t keep you safer than without it, like it does me . I’d not want to be without a good CGM. It is life-changing after all these years of going to sleep only to wake up to either too high, or too low bg’s. Having to test 17x a day for safety’s sake and piece of mind. Ah, I’m not going to bite my nose to spite my face because of some irritation with the company that makes my CGM.