Announced today, the Régie de l’Assurance Maladie du Québec (RAMQ) will now offer reimbursement for the DEXCOM G6 continuous blood glucose meter for people 2 years of age and over, living with type 1 diabetes (T1D) and that meet certain criteria (exception medication and device). The Dexcom G6 will be the first continuous blood glucose meter which enables the user to receive alerts and view blood sugar values and trends in real time without any action required.
To date, the only continuous blood glucose meter reimbursed by RAMQ has been the Freestyle Libre. However, with this system, the user must scan the sensor to view the current blood sugar level and its evolution of the past 8 hours and does not allow to receive alerts in case of high or low blood sugar. The FreeStyle 2 has certain alarms, but still needs to be scanned to see the blood sugar value. It is not yet covered by the RAMQ.
Unlike capillary blood glucose meters which measure blood glucose from a finger prick at a given time, continuous blood glucose meters consist of a sensor (on the skin) with an electrode (under the skin) which remain in place between 7 and 14 days and thus allow to have a blood sugar measurement at all times.
To be eligible for reimbursement, the person living with T1D must meet at least one of these criteria:
- non-attainment of patient-specific glycated hemoglobin (HbA1c) value, despite optimal management of the disease
- frequent episodes of hypoglycemia in the last year, despite compliance with a glycemia management plan
- inability to recognize or signal hypoglycemia symptoms
How to get the refund?
If you meet one of these criteria, your doctor will have to request payment authorization from the RAMQ. Most people who live with T1D meet these criteria.
The initial approval is usually given within a few days for a first 6-month period after which the doctor will have to confirm that the device is being used at least 70% of the time. The renewal will then take place every year.
For people who will obtain reimbursement for the DEXCOM G6, the maximum number of strips for capillary blood glucose measurements reimbursed by the RAMQ will be reduced to 100 strips per 18-month period. In the event that the person needs more strips, it will be possible to obtain an additional 100 with an additional request.
For full details, see the up-to-date Exception Medication List.