Ruairí Ó Murchú (Louth, Sinn Fein)
Link to this: Individually | In context

161. To ask the Minister for Health if she is aware of the restrictions the HSE is placing on diabetics getting access to CGM (continuous glucose monitoring); if she will be raising the matter of access restrictions with the HSE; the plans to expand the CGM scheme; and if she will make a statement on the matter. [52404/25]

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
Link to this: Individually | In context

Under the Health (Pricing and Supply of Medical Goods) Act 2013 the HSE has statutory responsibility for decisions on the pricing and reimbursement of medicines and devices. The Act provides a rigorous process for the assessment of new medicines and devices for reimbursement. The Act specifies nine criteria which must be considered. These include the health needs of the public and the clinical need for the medicine. All these factors, taken together, allow the HSE to make an informed decision on new medicines and devices.

HIQA published a Rapid Health Technology Assessment on Continuous Glucose Monitoring (CGM) for adults with Type 1 Diabetes in September 2023. Based on this the HSE introduced a number of initiatives from December 2023 onwards, to support access to continuous glucose monitoring (CGM) sensors while managing expenditure in the area.

In the first year since the introduction of the reimbursement application system for CGM sensors, 2,949 new patients have received reimbursement support for this technology. In December 2024, 19,861 patients were in receipt of CGM sensors under the Community Drug Schemes. In December 2024, 63% of new initiators on CGM sensors were commencing on a Preferred CGM sensor.

Reimbursement for CGM sensors applies to patients with type 1 diabetes who required insulin from diagnosis, based on the HIQA HTA.

Applications and appeals for all patients are reviewed centrally by the HSE Medicines Management Programme on a case-by-case basis. Clinicians can appeal decisions by submitting additional clinical information directly to the Programme.