Dexcom Delays Medicare Coverage of G6

#122

Dexcom issued a press release in October 2018 which is trivially able to be searched, located and read.

I am not (currently) in the rah-rah Dexcom club (but willing to go back if they self-correct) but they issued a press release. That is an easily verifiable fact.

There is substantially more involved in order for a Medicare recipient to receive a Dexcom G6 cgm then simply having Medicare approve it. The approval is a step in a much larger process.

I have no idea what sort of cover story you are speaking of but if it is something that somebody told to somebody who told to somebody who told to somebody — well — sometimes you get good information that way and sometimes you get not so good information.

#123

Name a large corporation that isn’t manipulative or dishonest at times. It’s not my nature to pick and choose my medical products based on some idealistic ideas about the company’s “morals”. I just buy what works for me. I couldn’t give a rat’s ■■■ about the rest.

#124

Complete nonsense. This and other practices (pharmaceutical companies lying to Congress that Vioxx was safe, that tobacco was neither cancer-causing nor addictive, etc.) are unethical and often illegal.

When you say “Name a large corporation that isn’t manipulative or dishonest at times” you make the blatantly false equivalence between DME product manufacturers and other companies, such a makers of clothing or notepads. It’s remarkable that I have to articulate this, but makers of health and medicine are required to abide by health and medicine regulation and laws, which when willfully ignored can cause significantly negative consequences. Problems of that severity with T-shirts or writing pads? Certainly you can acknowledge that differentiation - I hope.

#125

I cited and linked this page in my post. (I wish people would pay attention!)

For those who choose not to do so, my point was that they knew at that time that Medicare has approved G6, but described that approval as something that would happen in the future. They decided this “tweak” was necessary to simultaneously keep customers interested while suppressing the cause of the delay being the production facility.

Suppressing causal information is a bad habit with potentially serious consequences for the company doing so.

A more dramatic example is when, several years back, Muro 128 Ocular Gel had a crystallization problem caused by insufficient insulation in the shipping vehicles during the winter. These crystal caused eye damage to the cornea and elsewhere, such as scars that cannot be corrected and if serious enough can require corneal transplant. The problem was that the manufacturer (Bausch & Lomb) did not disclose this (neither to patients OR doctors), rather categorizing the problem as a “Voluntary Recall” that requires a user to have the symptoms and going to an ophthalmologist to determine what is wrong, which then causes the physician new to the issue to solve the puzzle. Even if the physician is aware of this, it can too late for the patient.

To me, Dexcom withholding the actual cause of the Medicare delay (i.e., their decision in how to handle the production/shipping problem) is the same unethical behavior. Also, keep in mind that DME manufacturers, being in the healthcare space, may well be obliged to abide by HIPAA and HIPAA 2 regulations, in which patients are defined as “interested parties” (along with doctors, et al), and so may incur some difficulties.

While the G6 issue is far less serious than the Muro problem, it is marching to the same beat.

1 Like
#126

No, I’m STUPID, and you are king. sheesh. Do you have to be so blatantly condescending? Carry on your griping without me. Dave out!

1 Like
#127

No need to get personal.
On the other hand if you need to vent, I understand.

Dexcom was quite clear that Medicare approved the G6. That is black and white. And from October of 2018 per Dexcom press release.
As FYI, the G6 itself was granted the iCGM designation by the FDA in March 2018.

Dexcom publicly stated in November 2018 that it intended to bring the G6 to Medicare eligible customers in early 2019. I believe this was generally understood to mean April 2019 although I think the most specific Dexcom had publicly stated at that time was “Early 2019”.

Dexcom then hedged a bit on February 21, 2019 and stated plans to begin shifting G6 to their Medicare patients “… in the near-term …” which when taken in context with the remarks preceding and following this statement could reasonably be interpreted to mean 2~4 months ballpark although clearly there was deliberate fuzziness here.

A small number of days later, Dexcom bumped the timeframe back futher via a FAQ on their webpage which announced that Dexcom will start shipping G6 to all Medicare customers in Q4 2019.

One could certainly make the case that Dexcom failed to live up to its stated intentions regarding when it would have the G6 available to Medicare patients. There is nothing however that could reasonably be seen as Dexcom being unethical with the delay.

2 Likes
#128

My Endo told me yesterday that the reason for pushing the date back was lack of manufacturing capabilities for the G6…

1 Like
#129

I totally agree with you.
I had no problem geting G6 3 month supply Dec 2018 through my work insurance.
Retired and went on Medicare Jan 1 2019
Come March 2019, each time I called was told “G6 not approved for Medicare”!
Ended up getting a G5 system, but only 30 day supply each month.
I feel I was misled, and lied to several times.
G5 is still much better than MM Guardian 3 CGM I’d been using, always hated it!
Think about this:
Today, if on Medicare, can ONLY get G5.
If I were still working, with my work insurance, could still get G6.
DEXCOM made that decision, because with limited manufacturing capacity, will get more money from their “non-medicare” customers.
How does this match Decom’s mission statement, where they will not discriminate based on AGE?

1 Like
#130

Ramping up manufacturing production always comes at huge cost of additional equipment, labor to train etc. so it makes sense to me that in a period of product shortages, Dexcom would concentrate more on their most profitable new customers so that they have more funds to ramp up faster thus being able to handle more of the less profitable Medicare patients sooner rather than later. In the meantime they are doing their best to handle all existing customers (including Medicare) while being severally hampered by unprecedented demand combined with unexpected technical issues with some of their products.

#131

IMO it’s worse than that, because DME manufacturers may be violating HIPAA regulations when they are dishonest to medical “interested parties” - which we are.

And yet, there are individuals on this site that justify Dexcom’s lack of disclosure because of the generality that companies do this.

For those reading this, I once again repeat that I am not addressing their production/shipping issues, but rather their dishonestly stating that they are waiting for Medicare to approve G6 coverage (now pushed to the end of 2019, but maybe longer) when that approval was in place October 2016.

Stuart

1 Like
#132

What evidence do you have that this is intentional, rather than something misspoken by Dexcom representative. There was a point where G6 was not yet approved by Medicare, and possibly some support staff did not get trained properly, particularly with transition in support.

The difference between G5 and G6 is not that significant, and Dexcom found an efficient way to deal with upgrade. Per website, Medicare G5 customers will automatically be transitioned to G6 when they have sufficient production, estimated to be 4Q 2019.

2 Likes
#133

“Dexcom G6® CGM System will be covered for Medicare beneficiaries, having met the category requirements for therapeutic CGM systems by the U.S. Centers for Medicare & Medicaid Services (CMS).” Has been Dexcom position all along. This has been nothing but the truth from what I can see since last October. Medicare approved the G6 last October and if sufficient good quality G6 supplies had been available in October, Medicare would have covered, however, they could not cover in October due to lack of sufficient available G6 production.
Dexcom hoped to have their production ready by April 2019 and that did not happen. Will it happen by Q4 2019? Dexcom sure hopes so and they are doing everything to meet that deadline. I am very happy that G6 is not being pushed on us older Medicare patients given all the purported issues the G6 has had. Many of us are thrilled to stay with the G5 until the G6 bugs are worked out or maybe even the G7 comes along first.
I don’t see the lies you are alluding to.

3 Likes
#134

I second that emotion. :slight_smile:

#135

I’m on Medicare and have been using a G5 for about 2 years now. I’ve had no problems getting supplies. But last summer I was diagnosed with gallbladder cancer and am now having chemo for it. One of the volunteers in the chemo lab also has Medicare and a G5, and she is having a devil of a time getting her supplies before she runs out. I think DexCom is having more problems than just G6 supplies.

#136

You are correct. Moreover, I am receiving a much higher percentage of bad sensors than prior to 2018. (Dexcom’s new facility went live in December 2017).

#137

Does she get them direct, or from a 3rd party supplier?

#138

She gets them direct from DexCom. She haz the same complaint I’ve heard on this site: have to verify coverage but no follow-through.

Rob

#139

The verify coverage came about mostly when Medicare numbers were changed from Social Security number to a new random number. Several months ago when Dexcom said they had to verify my coverage, I asked them if they had my latest ss number. When they read off the number it was the old one. I gave them the new one and was verified within 48 hours my order was shipped.

Ask them what exactly they need to verify and then make sure that what they will verify is actually correct or the ball can go back and forth for a few weeks.