All I’ve used is Dexcom for 12+ years. I have heard of people switching from one brand to another but they all have their pros/cons/quirks. Have you heard of the Eversense system? It’s an implant with an external device. I’m not ready to jump into that yet but a lot of people are.
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I think one of the downsides to Eversense 365 is finding a doctor that is certified to do the insertion/removal/insertion procedure. This was mentioned here earlier by someone. Just this morning I read on a sub Reddit of a person who has one about to expire and is having difficulty finding a doctor to remove/replace.
The one thing about Dexcom/Libre is we only need a doctor to prescribe not insert.
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It’s so funny you mentioned Eversense, because I was on the phone with them this morning. There are downsides (insurance reimbursement???, finding reliable doctors for insertion/removal and hearing that if it gets too hot it briefly stops working), but that’s why I was talking with them. I’ve basically worn Dexcom since it came out, but this issue is so frustrating.
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I just tried to find listing of approved providers (read inserters) on the Eversense site. All I could find for the US is references to going thru their distributors. If Everysense wants to crack into the mainstream, they’re going to have to do better than that. Why can I get a list for other countries, but not the US? Doesn’t make a lot of sense to me, I have interest in finding which local docs are authorized so I can have an intelligent discussion with my Endo (he’s not an “authorized” inserter). I won’t change Endo’s just to get info, but that seems to be Senseonic’s method. Any one with advice for an “interested” fact finder?
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I can think of several thing for the dearth of Eversense inserters/removers.
- Having to take time out of their busy schedules to do the training necessary to be certified.
- Endocrinologists and PCPs may not be not comfortable in cutting.
- General surgeons wonder why they have to be certified to do what would be the simplest of their surgical procedures.
- Dealing with the nightmare of the medical insurance industry, including getting their fees paid.
These are just off the top of my head. I am sure that I haven’t covered all the bases. But I feel these 4 are on target.
Number 4 may be why it is easier to find practitioners to do this procedure in countries that have aa working, efficient and effective health care system.
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The Eversense 365 website has a “do I qualify” page for interested people to register their contact info. Understanding CGM Cost: Insurance Coverage & Prices for Eversense 365
You’ll be called by a sales rep who has the inside info on who/where/when for the sensor insertion. It seems that Medicare insured have it the worst, not many doctors available/certified to do the insertion for Medicare. They seem to be steadily adding more docs to the list. I’ve had several call backs from the sales rep informing me of additional options for the insertion.
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My endo did the training but has never done the op. I don’t know how much the training costs in $$ but it takes time, PCPs don’t have that time. My squirrel works project is to get my endo to put one into me; he volunteered to contact the local doc who did it but I like my endo. This may take years but I am patient and always looking for something new.
I do remember the CPA who used to do our taxes fired me. I do hope that doesn’t happen with my endo, but that’s off topic.
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That lines up with endos may not be comfortable with cutting.
General surgeons are the likely ones to do this, but what is their incentive?
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Yes, that is the process I’m in right now. Sales rep called, answered some questions then forwarded my information to another person who is checking my insurance. I still have no information about doctors in area who can insert and remove. My endo does not do it.
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Both the docs are endos. I think mine said he learned on the earlier models; the 90 day ones, and didn’t see the point for something that only lasts that long, still required an adhesive patch (and an attached dongle of course) and apparently does sometimes migrate.
I received a call back after inquiring about the insertion. It was from an infusion center. They said they would do the insertion. I believe it is a nurse practitioner who is trained to do it. Cost was about $6000 without insurance. With insurance, it would cost about $300. This was just for insertion. It does not include any of the supplies or the removal a year later. The infusion center said the removal cost would be higher, but they had no cost for that.
I think I’m going to wait and see. Up until this “goosenecking” issue, I’ve had a good experience with Dexcom. I think since it’s a manufacturing issue, Dexcom could have handled this much better, but at least for now they are replacing the failed sensors.
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IRC that is about the Medicare approved amount. From what I could make out from the Medicare billing codes the procedure after initial insertion has a separate billing code for about the same amount which covers removal of the old one and insertion of the new one.
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@drrps3 I’m surprised at the cost, particularly if removal is even more. Seems like a lot of G7s could be had for the price and the inconvenience seems worth it. I’m with you, I think I’ll be sticking with the G7 or other alternative!
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Appreciate the info! The last time I trusted a manufacturer and filled out their form (very similar to this), I ended up with an unintended script the manufacturer told the doctor I wanted after it had been sent to my regular pharmacy. First I heard of it was from the pharmacy telling me it was ready for pick up? Took me a year to get it removed from my records (on the good side, I found another script in my records for a medication I never asked for or took). I chastised both the manufacturer for misrepresenting me and the doctor’s office for complying without discussing with me. Perhaps a phone call might be better?
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I wouldn’t worry about it. They explained to me that an appointment is made/confirmed with the clinic doing the insertion, then the sensor is shipped to the doctor who will insert it. That clinic handling the insertion also handles billing and reimbursement for the sensor and the procedure. So (at least under Medicare) the sensor does not show up at your front door in a FedEx box. The latest conversation I had was insertions are being scheduled for September in Seattle area for a clinic in Tacoma.
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6-7 years ago when the first (90 day) sensor was being marketed by Eversense, they had a cash pay program called the Bridge program. This was when I was still on private insurance which did not cover Eversense so I went for it. My recollection is each sensor was $99 and they referred to local doctors for the insertion and removal. I paid a local endo $150 for an insertion, then $150 for the removal and the second insertion which included the final removal. Procedure took about 15 minutes.
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Is there a small scar or is any evidence of the procedure gone by now?
Yes, a scar about the size of a raisin sliced in half, looks a little like a thumbnail trimming was glued to my skin. The scar does not bother me but I am guessing would be a turnoff for many people who value the smoothness of their skin.
It’s possible my scarring was worse than the typical customer…one of the sensor insertion sites became infected about 1-2 weeks after the insertion and I had to go back and have it removed and reinstalled.
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So it would seem we have the option of a small scar or having larger device showing. If its a straight up choice based on that, think I’d go for the scar. I heard Joanne Milo (SoCal Loopers) say on a LoopAndLearn video she had her Eversense 365 put in an “off label” location and its working fine…the mind wonders on what location(s) that could be! Also, heard an Eversense exec saying they are in animal tests of a version that doesn’t require the external “transmitter”; it’s supposedly about 2x the length to account for battery and antennae, or about 1.4” long currently, and lassting a year. Eversense is supposedly skipping reducing the transmitter size and going straight to eliminating it altogether.
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They are testing clinically very soon and looking for users. They are doing one withtge transmitter built in and a second with a scan feature is what I’ve been told.
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