What would you do?

I was wondering what you'd do....

I was eligible for a new Dexcom at the end of Aug. I called and asked when the new and improved Dex's would be available. I told them I could wait, that I was already at 100% covered. They told me they didn't expect them until 2013 at the very earliest, and urged me to just order one now "so that you'd be eligible for the new one sooner next year".

Viola, at the end of Sept Dexcom announced the launch of the new G4. It is more sensitive, smaller, and can detect from 20 feet instead of 5 feet. I called to exchange it, since I have not opened my new one yet. They told me I was out of the 30 day time limit (barely), but I could either pay $400 to "upgrade" or wait another year.

I spoke with several people there, and they told me things like "If we made an exception for you, we'd have to make one for everyone" (I countered with "Well, not everyone IS asking!", and "No one knew anything until that day", and "Sorry, 30 days is 30 days."

Would you keep pushing or give up? I feel like it is me, that I'm just a poor negotiator. Thoughts?

Agh that stinks, Annie. You got a bit unlucky. If you feel like you have the energy for it, you could keep pushing, but they really do have to draw the line at some cutoff date, and there are unavoidably going to be people who are disappointed by it. Short of you raising an absolutely cataclysmic stink, I doubt they're going to budge, if only out of holding the line for their own sanity.

Do you have a sales rep who spoke to you personally about using the device when you started? Still in touch with that person? You could try that angle, but not sure.

Before I knew whether I would be able to get a G4, I had easily made peace with using my Seven+ for another year. Even if they won't make an exception, keep in mind that you are still using the best CMGM currently available (I know: I was unfortunate enough to use a competitor's CMGM for a couple years prior to starting on the Dexcom) and it's only for another year. The Seven+ is certainly no slouch.

I had this happen to me once with a Medtronic pump I actually received my pump the same day they released the next model. They had no free upgrade grace period so I eventually ended up paying the full pathway price to upgrade. I was within the 30 day return period but I would have had to go off the pump and wait while the whole thing went through the insurance process again.

They have to cut things off somewhere and hold firm on that line, as there’s always going to be someone just on the other side. I don’t think you’re a poor negotiator. I think it’s the line they’ve drawn and they can’t deviate from it without a whole lot of problems. If it’s any consolation I know how much it bites though. After having been through it once, I don’t upgrade unless I’m willing to live with that sort of situation again.

In all honesty I think I would do what you have done (order it early, then be very upset that it worked out the way it did) and I would probably call and complain and be upset with everyone for misleading me and yes, I'd probably keep trying . . .

However, in fairness, it probably isn't really Dexcom's fault that they predicted a later date since everything is taking so long they didn't want people's hopes up. And they probably can't afford to absorb the cost of too many systems that insurance companies won't cover. And so since I want the company to succeed and be able to continue on in the field - initiating new products and advances - I guess I think you probably need to do what they said - which is pay or wait. But it's way easier for me to say that since I'm not in the same boat.

i got one in august and was told the same thing. No new sensor for at least a year. i did not know that the new one was out! Thaey are a company i will not support after this year! I will write them letter aftr reading your words. mini med will come out with one better than their old one soon.

let us know what you do.

Do not forget, that this "release" is solely up to the Government. Dexcom could not know for sure when the FDA was going to bless them and us with their lofty approval of a new system. Dexcom is a business that is trying to improve our lives and make a couple of bucks to keep folks working, the blame does not lie with them. My Dex is not perfect and I would love for the receiver to be near me not on me always, but I would not give it up. I am upgrading out of my own pocket because of these conditions, it is worth it to me for the convenience of a product produced to make my life easier/better. Same reason I like my washer/dryer, do I need them? No, do I buy them anyway? Yes, they make my life better:)

I'm very doubtful that Medtronic's new CMGM will be better than either Dexcom unit. It will have bells and whistles like "auto basal shutdown" etc., but none of those extras matter that much if the core technology for detecting blood glucose isn't that great. Certainly as of the Revel system, Medtronic was way, way behind the Seven Plus.

Unless Medtronic has entirely scrapped and reinvented their glucose measurement technology from the ground up, which I doubt, I don't see them catching up to the accuracy of the Dexcom, probably either model, current or new. So Lisa, I wouldn't be too ready to abandon Dexcom over this in any case. There's not much they could have done differently.

I dont know much about the system , release of items, etc. I just felt Dex rep led me astray , lied to me and did not care about me as a consumer. After your educating me with regard to the release of the new Dex, i feel better about what transpired. Thanks!

Do not feel bad - I consider myself a pretty good negotiator since it's what I do for a living. I have had the exact same experience - ordered a new one at the end of August, after speaking to everyone at Dexcom - who said they did not expect the new one before March next year - and now getting slammed with the $400 charge. I have spoken and escalated to everyone I can get my hands on at Dexcom - locally and at corporate - and they all say the same thing. I have told them point blank that the policy is wrong, and if they are going to charge an upgrade fee they need to charge *everyone*.

They tried the "we're unprofitable" comment and I said "join the club. My family has been "unprofitable" because of diabetes for years". When they told me I was lucky to have ANY upgrade program, I said somehow I don't feel that lucky. I also don't feel bad about asking for some kind of dispensation from Dexcom because they are literally getting paid twice within a week because of the "unexpected". They are making out just fine by me.

I really like having a CGM and I want the company to be profitable. Since I have an infant / toddler with diabetes who can't talk or express it has been vital in keeping him healthy and seizure free. However, to say they are handling this very badly is an understatement. I feel very misled, and with their complete lack of support of children - the sales rep won't call me or help me because I am off labeled ("I can't talk to families with kids!!!), the alarms, range, and software are not even close to adequate for an infant / toddler with diabetes, the case in and of itself is maddening since a two year old is not going to read their own sensor upside down - I am a very, very frustrated customer of Dexcom.

well add another user who upgraded in the last 2 days of August....

Even though they are unprofitable we know they sold at least 4 in a week at the end of August and 12 boxes of sensors ... ;-)

I know that Dexcom is whom you're dealing with directly, but it really makes sense to remember that they are only one piece of a larger puzzle that includes your insurer and the FDA.

I am sure Dexcom would love to have every single user upgrade to the G4 the instant it comes out. They simply cannot afford to give 11/12ths of their users (every patient not within the 30 day grace period) the new G4 units. That is what they would have to do if they didn't set a cutoff date.

The reason is that the one who pays for the G4 if you don't pay out of pocket is your insurer. You can bet that that the 30 day grace period is what Dexcom was able to bargain insurers into paying for. There is no reason in the world that if Dexcom could get the insurers to pay for everyone who wanted to upgrade, regardless of where they are in their warranty cycle, they wouldn't do so. Absent that, they have to set a cutoff somewhere.

If my child were diabetic, I'd probably choose to use a Dexcom CMGM for them like you do, because it's the best available. But Dexcom really would be breaking the law if they advocate or claim to support what the FDA classifies as off-label, unapproved use. That's the law, and companies are severely sanctioned if the FDA catches them breaching it.

These views and concerns have helped me make peace with the situation.

i do not plan to upgrade. i will keep my dex and use it sparingly with the sensores I have. Maybe they should sell these old sensors at a cheaper price to anyone they " stuk it" to in august?

Per the last comment, I'm not asking them to break the law - I am asking them to add some flexibility in their product for children, especially the little ones. When I have asked for specific items like raising the low to 120 (little kids are run higher), having a beep only alarm (a little one will only respond to noise, not vibrate, and hand an adult the sensor - beep and vibrate waste battery life), having an alert on ??? (he'll have it on him or by him when he's sleeping and will have no clue it's not working - although I think many people would want that), having a case that doesn't require it to be read upside down, etc etc Dexcom always says "we only develop and market to adults, not children". It wouldn't be a huge stretch to make it more kid friendly, while still catering to adults.

@ Biomuse

Im sorry to disagree but there is no Insurance involvement in the upgrade. Not everyone has insurance or has coverage for cgms

I understand how frustrating that is. But, believe it or not, if someone at Dexcom said to you - “yes, that’s a good idea and we’ll take that into consideration,” they would already have broken the law. Because if they were to reply to you in that manner, they would be implying that using their CMGM is ok for children. That is prohibited. Regardless of what they actually do, the only answer they are permitted by law to give you is the one they are giving you.

I’m sure Dexcom has safety trials going on right now to get FDA approval for using their device with children. But until that approval is received, they won’t be able even to imply that their products can be used that way.

Insurance is involved because that is the only other way, besides out of pocket, that Dexcom can be paid for what it sells. Many people (not all) who are insured and wait to upgrade until their CMGM is out of warranty can have the upgrade covered under insurance, because the new unit will be considered to be a replacement for the old, out-of-warranty unit, which replacement most insurers have agreed to cover. If it’s not covered, and the patient doesn’t pay for it, then Dexcom pays for it by giving the unit away.

My understanding is that the 'free' upgrade for those within 30 days is because they have a 30 day return policy. So it's more of an exchange/return and saves everyone the hassle/cost of actually processing a return and new purchase.

And they are doing so pro-actively, rather than only doing so for those that happen to 'hear' about the new release within their 30-day window.

As for insurance coverage for those that choose to upgrade ($400), why should insurance cover it, when the 'old' unit still works fine, and under warranty.

I guess I would be disappointed if I had just missed the deadline, but would not blame it on Dexcom.

We agree to disagree
What I was talking about is the offer Dexcom made to people who JUST upgraded and got the Old Generation system.
What you are saying is that anyone who paid cash for the Dexcom would NOT be eligible for the 30 day upgrade Dexcom is offering. That's simply incorrect.
Again - in the case of the 30 day upgrade Insurance is NOT involved.
They are in fact giving away the new system to those people who JUST purchased. It maintains customer satisfaction and More importantly it keeps people off the fence waiting for the next generation.

The biggest issue is that for those of us who purchased a new system at the end of August is that we feel fundamentally misled. Everyone's understanding was that the new system would not come until Q1 next year, and we were encouraged to buy a new system now so that we would be eligible sooner for the new system next year. Then when it came early, there was no accommodation for those of us who were misled - they just say "oh, sorry, I would be mad too, but tough". I would have been happy with any kind of accommodation - discount, free box of sensors, etc - instead it was "tough, we didn't know, where's my $400". Then how was I supposed to know?!? From a customer service perspective, that is an extremely poor response and makes it the customer's problem.

I have to have the new system because I am up at least four times a night checking the receiver by his bed. Now with a 20 foot range, I am hoping I can have it by my bed and maybe get some sleep. I can start living more like a normal human being, rather than the vampire existence I currently inhabit. I have no choice.

On top of the fact, those of us with small kids get very little to no support due to their "we don't consider children in our product". If they would just keep us in mind while they develop it - just some added flexibility - it would be a huge help, but again it's "tough, we only develop for adults".

By the way, they have not even begun to submit the Dexcom for use in children for approval by FDA. They said they would only start that "sometime next year".

Amy I happy that I have a CGM? Absolutely. Am I happy with Dexcom? Absolutely not.

I can understand your frustration. I'm sorry to hear the Dexcom customer service treated you that way. That is unacceptable. But they probably received many calls like yours, and I could see it would get challenging.

I'm curious if in August, Dexcom had told you there was a 60-40 chance of the G4 being available in Q1, vs earlier or later. Would you have waited ?
What if FDA delayed longer, and it wasn't available until Q2 ? Would you have been misled ?
I know you feel that way, but I don't see how they misled you when they were dependent on FDA approval, and could not guarantee any date. I think they provided an honest 'best guess'. I saw several different sources that anticipated a Q1 release, and anything earlier would be a bonus.

If you have a local Dexcom rep, I would suggest contacting them, rather than the general Dexcom customer support, which tend to have 'scripts' to follow. You might be able to get a 1 week trial G4 to check if the extended range will reach your bedroom, and confirm your decision to pay for the upgrade.