-
Americas
-
Asia & Oceania
-
A-I
J-Z
EMEA Thought Leadership
Developing IQVIA’s positions on key trends in the pharma and life sciences industries, with a focus on EMEA.
Learn more -
Middle East & Africa
EMEA Thought Leadership
Developing IQVIA’s positions on key trends in the pharma and life sciences industries, with a focus on EMEA.
Learn more
Regions
-
Americas
-
Asia & Oceania
-
Europe
-
Middle East & Africa
-
Americas
-
Asia & Oceania
-
Europe
Europe
- Adriatic
- Belgium
- Bulgaria
- Czech Republic
- Deutschland
- España
- France
- Greece
- Hungary
- Ireland
- Israel
- Italia
EMEA Thought Leadership
Developing IQVIA’s positions on key trends in the pharma and life sciences industries, with a focus on EMEA.
Learn more -
Middle East & Africa
EMEA Thought Leadership
Developing IQVIA’s positions on key trends in the pharma and life sciences industries, with a focus on EMEA.
Learn more
SOLUTIONS
-
Research & Development
-
Real World Evidence
-
Commercialization
-
Safety & Regulatory Compliance
-
Technologies
LIFE SCIENCE SEGMENTS
HEALTHCARE SEGMENTS
- Information Partner Services
- Financial Institutions
- Global Public Health
- Government
- Patient Associations
- Payers
- Providers
THERAPEUTIC AREAS
- Cardiovascular
- Cell and Gene Therapy
- Central Nervous System
- GI & Hepatology
- Infectious Diseases and Vaccines
- Oncology
- Pediatrics
- Rare Diseases
- View All
Impacting People's Lives
"We strive to help improve outcomes and create a healthier, more sustainable world for people everywhere.
LEARN MORE
Harness the power to transform clinical development
Reimagine clinical development by intelligently connecting data, technology, and analytics to optimize your trials. The result? Faster decision making and reduced risk so you can deliver life-changing therapies faster.
Research & Development OverviewResearch & Development Quick Links
Real World Evidence. Real Confidence. Real Results.
Generate and disseminate evidence that answers crucial clinical, regulatory and commercial questions, enabling you to drive smarter decisions and meet your stakeholder needs with confidence.
REAL WORLD EVIDENCE OVERVIEWReal World Evidence Quick Links
See markets more clearly. Opportunities more often.
Elevate commercial models with precision and speed using AI-driven analytics and technology that illuminate hidden insights in data.
COMMERCIALIZATION OVERVIEWCommercialization Quick Links
Service driven. Tech-enabled. Integrated compliance.
Orchestrate your success across the complete compliance lifecycle with best-in-class services and solutions for safety, regulatory, quality and medical information.
COMPLIANCE OVERVIEWSafety & Regulatory Compliance Quick Links
Intelligence that transforms life sciences end-to-end.
When your destination is a healthier world, making intelligent connections between data, technology, and services is your roadmap.
TECHNOLOGIES OVERVIEWTechnology Quick Links
CLINICAL PRODUCTS
COMMERCIAL PRODUCTS
COMPLIANCE, SAFETY, REG PRODUCTS
BLOGS, WHITE PAPERS & CASE STUDIES
Explore our library of insights, thought leadership, and the latest topics & trends in healthcare.
DISCOVER INSIGHTSTHE IQVIA INSTITUTE
An in-depth exploration of the global healthcare ecosystem with timely research, insightful analysis, and scientific expertise.
SEE LATEST REPORTS
FEATURED INNOVATIONS
-
IQVIA Connected Intelligence™
-
IQVIA Healthcare-grade AI™
-
-
Human Data Science Cloud
-
IQVIA Innovation Hub
-
Decentralized Trials
-
Patient Experience Solutions with Apple devices
WHO WE ARE
- Our Story
- Our Impact
- Commitment to Public Health
- Code of Conduct
- Environmental Social Governance
- Privacy
- Executive Team
NEWS & RESOURCES
Unlock your potential to drive healthcare forward
By making intelligent connections between your needs, our capabilities, and the healthcare ecosystem, we can help you be more agile, accelerate results, and improve patient outcomes.
LEARN MORE
IQVIA AI is Healthcare-grade AI
Building on a rich history of developing AI for healthcare, IQVIA AI connects the right data, technology, and expertise to address the unique needs of healthcare. It's what we call Healthcare-grade AI.
LEARN MORE
Your healthcare data deserves more than just a cloud.
The IQVIA Human Data Science Cloud is our unique capability designed to enable healthcare-grade analytics, tools, and data management solutions to deliver fit-for-purpose global data at scale.
LEARN MORE
Innovations make an impact when bold ideas meet powerful partnerships
The IQVIA Innovation Hub connects start-ups with the extensive IQVIA network of assets, resources, clients, and partners. Together, we can help lead the future of healthcare with the extensive IQVIA network of assets, resources, clients, and partners.
LEARN MORE
Proven, faster DCT solutions
IQVIA Decentralized Trials deliver purpose-built clinical services and technologies that engage the right patients wherever they are. Our hybrid and fully virtual solutions have been used more than any others.
LEARN MORE
IQVIA Patient Experience Solutions with Apple devices
Empowering patients to personalize their healthcare and connecting them to caregivers has the potential to change the care delivery paradigm.
LEARN MOREWORKING AT IQVIA
Our mission is to accelerate innovation for a healthier world. Together, we can solve customer challenges and improve patient lives.
LEARN MORELIFE AT IQVIA
Careers, culture and everything in between. Find out what’s going on right here, right now.
LEARN MORE
WE’RE HIRING
"Improving human health requires brave thinkers who are willing to explore new ideas and build on successes. Unleash your potential with us.
SEARCH JOBSInstitute Report
Innovation in Diabetes Care Technology: Barriers to Reimbursement
Jul 30, 2020
About the Report
The clinical and financial burdens placed on the healthcare system by growth in chronic diseases has spurred the search for new care models that generate greater healthcare value, such as those leveraging digital medicine products. Initial studies have shown that improved access to and optimal use of diabetes digital medicine products — for example, continuous glucose monitors (CGMs) and connected insulin delivery devices — can have positive clinical, psychosocial, and economic impacts on people with diabetes and the healthcare system that serves them.
A critical need for digital medicine products has simultaneously grown during the COVID-19 pandemic, as patients receive healthcare services at home. The importance of these products is highlighted by CMS’s easing of requirements for access to CGMs during this period. However, to obtain and utilize these products stakeholders face several challenges like navigating the current reimbursement landscape. As more digital medicine products become available and enable a new era of care, modernizing the reimbursement paradigm will facilitate their seamless integration into the healthcare system and their optimal use.
Report Summary
This report explores the current coverage and reimbursement paradigm for digital medicine products, which was largely codified before digital devices became prevalent, and examines possible barriers to access and use. Modernizing the reimbursement landscape across the U.S. healthcare system can aid in optimal access to and use of these new, and increasingly used, devices. Challenges exist in the form of coverage differences between insurance types such as commercial and Medicare. Additionally, healthcare providers and other stakeholders face challenges regarding reimbursement for time spent using these products and their expertise advising patients. Specifically, significant time investment is required for healthcare providers (HCPs) to train themselves on how to use these technologies, initiate patient use, and support the ongoing needs of patients that may not be reimbursed.
At its conclusion, the report presents short and long-term solutions that offer opportunities to better integrate digital medicine products into the U.S. healthcare system. Changes in policy to reimburse for HCP time and expertise may help optimize use of diabetes digital medicine products in the longer term. For example, the healthcare system could benefit from the development of new CPT codes to allow for HCPs to be reimbursed for training on the use digital medicine products and for patient coaching and counseling. Modifying current CPT codes to allow for more frequent remote analysis and interpretation of diabetes digitally collected data, modifying coding frequency, and expanding eligibility to the wider clinician team involved in care could similarly encourage adoption.
Key Findings
For people with diabetes, gaining access to critical devices and supplies can be complex and requires navigating multiple coverage components of their insurance plans.
Potential Impacts from the Current Reimbursement System
- For key products, such as continuous glucose monitors (CGMs), connected insulin pens, hybrid closed-loop systems, and smartphone applications, transitioning from commercial insurance to Medicare, as an example, impacts coverage requirements, and the same types of products may or may not be covered.
- From a health system perspective, variations in coverage between federal, state, and commercial payers may have an impact on health disparities, as access to technologies can vary based upon insurance type.
- In order to respond to the rapid advancement of technology and new, emerging paradigms of care, there is a need to re-evaluate the current system of reimbursement to allow for a more flexible and modernized approach.
Healthcare providers play a critical role in integrating technology into the healthcare system, and the ways in which they educate, personalize, and coach diabetes patients can have a direct impact on the uptake and outcomes of digital medicine products.
Key Plays and Roles of the HCP Care Team
- Providers need to ensure they have knowledge about current diabetes digital medicine products, stay up to date on recent advances, and are aware of changes and nuances of reimbursement systems, but investing this significant amount of time is costly.
- While CPT codes do exist for digital medicine, these do not fully cover HCPs to support PwD in managing their diabetes with digital medicine products nor do they reimburse for their time initiating these products with patients or training them.
- In order to support the uptake of digital diabetes products, policies could be adapted to restructure the current reimbursement system such as by introducing new CPT codes to account for healthcare provider time and expertise.