The peak body representing GPs has said it is “nonsensical” that GPs cannot approve continuous glucose monitors for diabetes patients, and patients say the rule may leave them hundreds of dollars out of pocket while they seek authorisation from a diabetes specialist.
On 1 July the government announced access to subsidised continuous glucose monitoring products for patients with type 1 diabetes would be expanded via the National Diabetes Services Scheme [NDSS]. However, the NDSS stipulates only doctors who manage diabetes as the main scope of their practice and diabetes educators are authorised to certify patient access forms for subsidised monitors.
Continuous glucose monitors allow people with diabetes to track blood sugar levels, and are essential for many of the 130,000 Australians estimated to have diabetes to effectively manage their condition.
A diabetes patient in Victoria, Melody, told Guardian Australia the wait to see a diabetes specialist, such as an endocrinologist, was up to six months.
Melody fears if she cannot get an appointment with a specialist who can authorise subsidised access to the monitors, she and other diabetes patients in similar positions will in the meantime have to pay upwards of $700 for a 90-day supply of monitoring.
Prior to the change to access, the glucose monitoring machines were only subsidised for those under 21 or those with a concession card.
The president of the Royal Australian College of General Practitioners [RACGP], Dr Karen Price, said while she welcomed the expanded access under the NDSS, GPs must be included among the health professionals authorised to certify glucose monitoring access forms.
In a letter sent to the federal department of health, Price wrote that managing patients with diabetes was something GPs did regularly. Yet the glucose monitoring access form states “NDSS cannot approve forms that have been certified by GPs” and that “this is an Australian government policy decision”.
The department of health said the decision to exclude GPs from the authorised certifier group was based on expert advice from the Australian Diabetes Society and the Australian Diabetes Educators Association.
“The RACGP is disappointed we were not consulted and wishes to seek clarification regarding the rationale behind this decision, and recommends that it is reconsidered,” Price wrote to the department.
“People with T1DM [type 1 diabetes] are managed by a healthcare team, which GPs are central to. It is unclear why other members of this healthcare team are able to sign this form and GPs are not. As it stands, this decision creates unnecessary barriers to patient access to appropriate and timely care.”
Price told Guardian Australia that “it is nonsensical that GPs can’t approve glucose monitors” and she hoped common sense would prevail.
A joint statement from Diabetes Australia, the Australian Diabetes Society and the Australian Diabetes Educators Association provided to Guardian Australia said the groups “recognise the concerns of the RACGP … and have reached out to the RACGP with the view to working collaboratively to best support people living with diabetes”.
The CEO of the Australian Diabetes Society, Associate Prof Sof Andrikopoulos, said type 1 diabetes was a complex condition that required the use of insulin, a potentially dangerous medication, and required education and upskilling or specialist care.
“Diabetes technology, which supports the delivery of insulin, is rapidly evolving, complex and requires considerable training and experience to stay up to date,” he said.
“This can be very challenging, even for specialised diabetes health professionals which is why we advised that the training and support to commence using diabetes technology should be provided by specialised diabetes health professionals – endocrinologists and Credentialled Diabetes Educators. A GP chronic disease management plan provides five Medicare-subsidised visits to allied health professionals, including CDEs.”
Diabetes Australia’s group CEO, Justine Cain, said anyone experiencing difficulty getting an appointment to see a specialised diabetes health professional should contact the NDSS Helpline on 1800 637 700.
