Perhaps if Congress will finally allow Medicare to negotiate prices like every other “insurance” org…and perhaps limit Pharmacy Benefit Managers profit margins (don’t think eliminating them is likely or possible)…it would drive CGM and other costs lower across the board…
Maybe but some of the prices in other countries are comparable. Abbott sells Libre 2 sensors for about GBP48 (one sensor excluding VAT, not CGM but comparable tech), the retail price in the US for 2 sensors is about $100 - about the same.
Dexcom seems a little different. They are selling a one year supply for GBP1906, so GBP159 for a month (3 sensors + 1/3 of a transmitter) but IRC Dexcom isn’t approved (for coverage) in the UK. I would assume the UK price is the bottom line where customers are paying the whole price themselves.
Abbott’s price is the customer price too, apparently, because they don’t offer “discounts” so it is covered at that cost by the NHS.
Meanwhile I just paid $250 for a G6 transmitter with a “retail” price of $300 (so the insurance company negotiated a nominal $50 discount). Last year WalMart stated $1250 for three months of sensors (3 boxes - their fictional cash price was actually not a multiple of 3!) I don’t have a post-discount figure for the sensors - after my skiing accident at the start of last year I didn’t pay for anything - however I would guess that it is 20% too, meaning USB5000 for a year of sensors and transmitters. So that’s 2.5 times what would be expected based on the UK price.
I don’t think changes to the MediCare rules will directly influence CGM prices. DexCom have been charging that very high price for a long time and MediCare didn’t cover CGM at all for much of that time. The MediCare budget isn’t going to go up - it is 12% of the whole federal budget and that just covers health care for people over 65!
What might happen (I’m obviously speculating) is that reduction of prices for necessary medications, like insulin (GBP14/10ml Fiasp in the UK vs $283/10ml Fiasp in the US - 20 times the price), will free up MediCare money to expand things like CGM coverage. That might come with negotiated price reductions, particularly with Dexcom, but we’re not talking about a 20x markup.