DexCom-CGM

Emily Goodson has a good post at the IBM blog, HealthNex, on some of the remote monitoring products available on the market. She rightly notes that the technology required for these kinds of products is readily available, and asks if the remote monitoring market will ever really take off. (you can read my reasonably coherent response there.)

In related news, Reuters has a story on the slow adoption of DexCom's very cool diabetes monitoring system (more on product here). The cost of their wireless sensors ($50 each and replaced every 3 days) has limited insurance companies and Medicare reimbursement to, well, zero. DexCom's stock fell 17% after a stock analyst lowered DexCom's stock from "outperform" to "neutral" on reimbursement concerns. Medtronic has a continuous glucose monitoring (CGM) product, and Abbott Labs has one in development (which they acquired with TheraSense).

"The technology, just to have real-time continuous glucose
monitoring, that is a big thing. We've been waiting for that for years
and years, and now it's here," said Dr. Robert Gabbay, director of the
diabetes program at Pennsylvania State University College of Medicine.

Beyond
the expense of the disposable sensors, the DexCom monitor costs about
$800, while the Medtronic device costs about $1,000. Medtronic also
recently introduced a glucose monitor combined with an insulin pump
that sells for about $2,100.

While some patients would clearly benefit from CGM, reimbursement will hinge on developing criteria for identifying those patients and demonstrating a return on the additional costs for payors. DexCom has said they expect reimbursement for CGM to take 12 to 24 months. In the interum, the lobbyists are out in force:

DexCom supported Medtronic's request for reimbursement from Medicare at
a recent hearing, and members of Congress have sent letters to the
agency in favor of reimbursement, Kemper said.

Figuring out the money (especially reimbursement) is a common reason why most health care innovations fail.