Unitedhealthcare decision — a step backwards for pump access (AGAIN)

Medtronic Pumps are NOT SAFE! I know because mine nearly killed me a year ago due to a software bug.

The problem is that MM has not designed their pump such that the software can be updated. Thus, a known easily fixed bug, like the one that nearly killed me, cannot be fixed for current users.

The other NOT SAFE aspect of MM pumps and their inability to be updated is that technology for the average user will be 2 years out-of-date. (Life of pump = 4 years; so users are locked into tech up to 4 years old!)

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Did you lodge a complaint with the FDA? I sent in a report many years ago. I haven’t had the need to do so recently…(but then, I’m not on a 670 and automode…something I want no part of). Was your issue with a 670? sensor issues?

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Yes, I filed a complaint with the FDA & had a good discussion with them about it. My pump is an older one – Paradigm 523. It turns out you can easily ‘butt dial’ the max bolus in your sleep due to menu wrap from 0 to 300 for carbs! All you have to do is roll across the buttons and then back to ACT. MM said they stopped the menu wrap in newer pumps because this has happened to multiple users.

Tim

(Please excuse the brevity; sent from phone.)

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Except for some Advantage plans, Medicare does not cover Medtronic sensors because Medtronic has not done the work to have them approved for insulin dosing by the FDA.

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I’m not sure that Medtronic has done the work to have them approved for insulin dosing, as a practical matter. :slight_smile:

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Aside from those with UHC and don’t have a choice, the rest of us can (and should!) boycott Medtronic. Just think, even a 20% drop in sales for Medtronic’s pump division would be a big hit.

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I just dropped Medtronic for Tandem. I loved my 523 pump, but Tandem seems to be better positioned from a technology standpoint.

@Don4, I have been on a Medtronic boycott for ten years. So far, so good.

What I find the most frustrating is that UHG is so large. They are, for instance, the insurer for Target. So, if I am job seeking, can I ask them who their insurer is in an interview? Or, is that suspicious? If I do that, am I saying, “I am too expensive to hire.” Basically, anyone insured by UHG is out. Although, realistically, I’ve never trusted them and would be hard pressed to accept one of their insurance policies.

During an interview, I would suggest not to bring up salary and benefit questions.

That would be IMHO premature.

Do a good interview. Sell yourself. If you are offered a position, this is then the time to come back with hard questions about salary and benefits, working hours, anything. There is an order. One thing at a time.

I consider the entire package. If one company is weak on the benefits, perhaps they make up for it in salary. Or vice versa. As well, it depends on what your fallback position is.

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Thats good advice

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I’ve been using the Medtronics devices since 2012 and I’m currently on the 670G. There can be a lot of frustration that goes along with using the Smartguard feature. Once mastered it is a good system with a few flaws. Medtronics recently announced that they will introduce an updated Guardian sensor with will qualify for Medicare on or about 4/20. The huge influence that UHC has on the industry might carry over to other insurance providers.

That is a big change. It would require FDA approval. Do you have a link for the announcement?

By “Guardian” do they mean a stand-alone CGM; rather than the sensor that is used with the latest MM pumps?

CMS has historically approached covering CGM with the caveat that in order to qualify for coverage that the device must not include calibrations. Dexcom and others have succeeded with this mandate. Medtronics has played by the rules by going through the long process of FDA approvals. Recent technology has prompted CMS to look at this advanced tech with a different view. The ‘forward-looking statement’ for CMS coverage made by Medtronics is most likely a compromise between CMS and Medtronics along with the other players. Please see the link below.

The term ‘Guardian’ is the name used for the current sensor available from Medtronics. Looking at my latest shipment from Medtronics the label states ‘Guardian Sensor (3)’. This version of the sensor has dramatically improved the performance of the sensor.

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@JD112

I see no indication that CMS is changing requirements around cgm systems so as to allow Medtronic to have their systems covered without being held to the same established standards which Dexcom G5/G6 and the Abbott Freestyle Libre are currently held to.

Certainly if you have any links from CMS to the contrary, that would be very interesting to read.

CMS requires a cgm to be non-adjunctive in order to be eligible for coverage for Medicare. This means the FDA must have provided approval for dosing of insulin directly upon the cgm reading without the need for a fingerstick meter reading. This is not related to calibrations.

= = = =

Medtronic has a clinical trial listed as NCT03040414 which has been pushed back a few times (as shown online in the record of historical changes) and still is not reported as being in the enrollment stage. The clinical trial listing shows the estimated study start as March 30, 2019 with an estimated study completion date of June 29, 2020. This clinical trial was previously referring to the 690G however the name “690G” has now been removed in an update to the listing. It is possible this is still the study which Medtronic plans to use for their next pump and has decided to call their next pump the 780G rather than the 690G.

It is also possible that Medtronic has a different clinical trial that they will be using for the next model of their insulin pump. If anybody has a Clinical Trial ID number other than the one listed which appears to be intended for the next model pump from Medtronic, that would also be very interesting to read about.

In any event, Medtronic will have their earnings release and conference call next week on February 19th, 2019. At that time they will have a large amount of information released which undoubtedly would directly address many questions about specific product pipelines with timeframes.

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Is it Edgepark?

Yes it was Edgepark. They just changed this year to allow other suppliers, but the way they changed it still makes it restricted because they changed their rules to be “any DME supplier that is already in network for DME supplies will be in network for pump and CGM supplies, but no DME supplier has to start selling them if they don’t want to”. I have yet to find any other supplier worth a crap that is in network for DME and also sells insulin pump and CGM supplies, if there even is another besides Edgepark.

Did you try Byram?