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Determining Insulin Pump Need for Diabetics
Date:7/28/2009

WESTERVILLE, Ohio, July 28 /PRNewswire/ -- All doctors recommend diabetic patients control their glucose level, but how can they do this while preserving a normal lifestyle? By using an insulin pump and carbohydrate counting, a diabetic can maintain precise glycemic control and lessen the long-term effects of their disease. Still, because of the cost of insulin pumps and their supplies, health insurers often turn to independent review organizations (IROs) to decide their medical necessity.

"Using evidence-based criteria, IROs review the medical necessity of insulin pumps for health plans," said Seana Ferris, President of NAIRO, a trade organization of IROs. "They must weigh improved glycemic control, patient pump management, patient knowledge and lifestyle against the long-term cost of a diabetic's health care before approving a $6,000 pump that also requires hundreds of dollars a year for supplies."

When Insulin Pumps are Medically Necessary

Replacing injections, a pump delivers insulin 24-hours a day through a catheter under the skin. With a pump with carbohydrate counting, a patient can adjust insulin levels accurately for food intake and elevated or low blood sugar. "Health plans often cover pumps when they improve a patient's diabetic care and provide better control than multiple daily injections," said David Sand, M.D., Chief Medical Officer of an Ohio IRO, HMS-Permedion, and a pump-wearer. "They routinely cover pumps for patients with type-1 diabetes. The hope is that better glucose control lessens end-organ damage, which can benefit type-2 patients also."

Health plans may ask an IRO review the medical necessity for an insulin pump when daily doses of insulin don't achieve tight glycemic control and the hemoglobin A1c rises above the recommended seven percent set by the American Diabetes Association, or when hypoglycemia continues despite adj
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SOURCE NAIRO
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