Laura - I’m very interested in the Twiist pump. Its planned use of an algorithm derived from the DIY Loop makes it attractive to me. I’ve successfully used DIY Loop for eight years. There are a couple of open questions for me that cloud my hopes of potentially using this AID pump system.
The first is the insurance coverage it may receive. In an article posted by diaTribe, it offers this:
Although information is not yet available regarding the launch date of twiist, Sequel’s co-founder and CEO Dr. Alan Lotvin noted that the company plans to make the device available in pharmacies with a pay-as-you-go model for greater access and affordability.
According to Christopher Gilbert, VP of Marketing at Sequel, offering insulin delivery systems in pharmacies is often smoother for both patients and healthcare providers, and usually only involves a co-payment. Sequel’s goals are to remove cost as a barrier for people looking to start on an AID system and to allow people with diabetes to get started quickly, without making a long-term commitment, Gilbert said.
In contrast, commercial insulin pumps typically involve a four to five-year commitment and must be purchased through Durable Medical Equipment suppliers (i.e., Advanced Diabetes Supply, Byram Healthcare).
This looks like the path that Insulet chose for the Omnipod. It is available for pharmacy benefit only and does not qualify for DME (durable medical equipment) coverage. It would compare poorly with my Medicare DME coverage which covers 100% of my ongoing costs.
I have no problem with pharmacy benefit coverage, but elimination of the DME benefit is a deal breaker for me. Sequel’s webpage does not provide for any way to pose a question so I cannot ask them to clarify.
The second concern that I have is about the insulin formulations that may be used. I believe that Sequel only intends to use Humalog, but I’m not sure. I’ve used Apidra for over 15 years in my pumps and prefer not to switch. I know that I am allergic to Novolog; Humalog may work for me but why change something that has worked well long term?
The Tidepool AID contains many benefits not featured elsewhere. The targeted BG can be as low as 87 mg/dL. It displays and offers controls on my iPhone and Apple Watch.
Unfortunately companies avoid any specific consumer contact during its roll-out period and the company decisions that they make are often irreversible. We’ll just have to wait and see.