Diabetes decision reflects state drive to make appropriate health-care choices

A state program takes a look at whether technologies are actually making a difference. Sometimes, that leads to criticism.

A state program takes a look at whether technologies are actually making a difference. Sometimes, that leads to criticism.

Members of Washington’s Health Technology Assessment (HTA) committee got one step closer last month to deciding that the state should pay for diabetes monitoring tools for state-funded healthcare recipients.

Leah Hole-Curry, program director for HTA, said the draft decision, reached at a March meeting, "is more broad than what we have now."

Health Technology Assessment is a government board based out of Olympia that evaluates whether certain medical services should be paid for by Washington state. In recent months, HTA came under fire for questioning whether or not to fund glucose monitoring devices, the tools diabetics use to measure their blood sugar levels.

A Wall Street Journal editorial, entitled “The Pro-Diabetes Board,” accused HTA of cutting basic monitoring tools, which set off a string of online criticism from diabetics including calls that HTA’s evaluation was “death by bureaucracy.” Hole-Curry, however, took issues with the initial accusations, which appeared before the committee's decision, saying those criticisms were misinformed. “Near as we can tell, for the individuals that did provide public comment, the decision is consistent with what they asked for,” she said.

Those affected by this HTA decision are diabetics 18 years of age and under who are dependents of public employees, Medicaid recipients, and retirees. The monitoring tools in question include finger “test strips” and “continuous glucose monitoring” devices, both of which diabetics use to plan for meals, activities, and when to take medications.

Health Technology Assessment aims to evaluate health coverage to make decisions about what medical care is safe, effective, and has value. According to the Health Technology Assessments’ website, “as much as one-third of the nation’s total health care spending currently goes toward treatments that do not work.”

“The process itself is trying to use evidence and rely on science rather than only on budget cuts or only on manufacturer lobbying,” said Hole-Curry. HTA proposals are based on recommendations from a committee of 11 practicing clinicians in Washington and go through several drafts and public comment periods.

According to Hole-Curry, HTA’s draft decision puts no limits on glucose finger strip monitoring and, while continuous glucose monitoring wasn’t previously being reimbursed, it now will be reimbursed for individuals with severe diabetes.

“For us [the benefits of a review] are that we engage the public much more, we get practicing clinicians’ insight, because the decisions are tough ones, they’re not black and white and state agencies can use help to make good decisions to use state taxpayer dollars wisely,” she said.

The glucose monitoring recommendations have been published on Health Technology Assessment’s web site. HTA’s final decision will be made at the next meeting, in May.


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