Access to Continuous Glucose Monitoring through the NDSS
The Australian Government is now providing access to fully subsidised continuous glucose monitoring (CGM) products through the National Diabetes Services Scheme (NDSS). Subsidised access to CGM sensors and transmitters is available through the NDSS to children and young people aged under 21 years, living with type 1 diabetes, who meet specific criteria. The NDSS also provides subsidised access to insulin pen needles and syringes, blood glucose test strips, urine ketone test strips and insulin pump consumables.
Providing access to subsidised CGM sensors and transmitters may assist these children and young people, and their families, to better manage their blood glucose levels, and may reduce stress, anxiety and emergency visits to the hospital.
If you are interested in learning more about CGM and whether it might be right for you or your child, we encourage you to speak with your diabetes healthcare team to see if this could help you and your family in managing your or your child’s diabetes. You can also call the NDSS Helpline on 1300 136 588. The Helpline operates during 8:30am to 5pm Monday to Friday and from 9am to 12pm on Saturdays and national public holidays.
To be eligible for the initiative you must be registered with the NDSS. More information on registration with the NDSS is available by clicking here.
What is CGM?
A continuous glucose monitor (CGM) is a small wearable device that measures glucose levels throughout the day and night. It has alarms to let the user know if glucose levels are getting too low or too high, and what their glucose level is at any time, and whether it is stable or on the way up or down. These devices reduce the frequency of daily finger prick tests. Some models can work in conjunction with a compatible insulin pump while others send information to a CGM receiver or smart phone.
Eligibility to Access to Subsidised CGM Products through the NDSS
To access CGM sensors and transmitters through the NDSS, the child or young person will need to be assessed by an authorised health professional to determine whether they meet specific criteria and to ensure that the use of CGM will help as part of their diabetes management.
The authorised health professionals who can perform these assessments include endocrinologists, credentialled diabetes educators, and other health professionals specialising in diabetes (medical doctors, paediatricians or nurse practitioners).
You can view and download the Continuous Glucose Monitoring Eligibility Assessment form here.
The health professional will need to complete and sign the Continuous Glucose Monitoring Eligibility Assessment form, which can then be submitted to their state or territory diabetes organisation for processing.
Subsidised access is for CGM devices, which have alarms that alert the user when blood glucose levels are getting too low or too high. These include the Dexcom and Medtronic CGM devices. The subsidy will cover the full cost of sensors and transmitters (i.e., there will be no co-payment) but the cost of a receiver, if preferred rather than the use of an insulin pump or smartphone, will need to be paid for by the person with diabetes or their family.
To be eligible to access subsidised CGM products through the NDSS, the child or young person must meet the criteria in one of the following categories:
Category A – for children 10 years or younger
Children 10 years of age and younger with type 1 diabetes will be eligible for subsidised access to CGM with alarms if they fulfil ALL of the following criteria:
- the child is aged up to ten (10) years of age with type 1 diabetes; and
- the child is expected to benefit clinically from the use of CGM; and
- the family/carer has the willingness and capability to use CGM; and
- the family/carer has the commitment to actively participate in a diabetes management plan which incorporates CGM.
NOTE: A child who has been accessing CGM products through the initiative will continue to have subsidised access after they turn 11. They will not need to be reassessed under Category B.
Category B – for children and young people aged 11 to less than 21 years
Children and young people with type 1 diabetes aged from 11 years to less than 21 years will be eligible for subsidised access to CGM sensors and transmitters if they fulfil ALL of the following criteria:
- the individual is expected to benefit clinically from the use of CGM; and
- the individual or family/carer has the willingness and capability to use CGM; and
- the individual or family/carer has the commitment to actively participate in a diabetes management plan which incorporates CGM.
AND they fulfil ONE OR MORE of the following criteria:
- requent significant hypoglycaemia—more than one episode a year of significant hypoglycaemia requiring external, third party assistance; and/or
- impaired awareness of hypoglycaemia; and/or
- inability to recognise, or communicate about, symptoms of hypoglycaemia; and/or
- significant fear of hypoglycaemia for the child/young person or a family member/ carer which is seriously affecting the health and wellbeing of the child or young person or contributing to hyperglycaemia as a reaction to this fear.
For young people in either category, subsidised access to CGM sensors and transmitters will cease once they reach 21 years of age.
How do I Access Subsidised CGM Products through the NDSS?
Once your eligibility form has been submitted and processed, you will be contacted by a NDSS Agent to confirm your eligibility for access to subsidised CGM products.
If you are a new user of CGM products, a starter kit will be supplied to the authorised health professional nominated on the form. The health professional will then assist you to set up and operate the new CGM.
After the initial set up, or if you are already using CGM, you will be able to order CGM products through any NDSS Access Point, usually community pharmacy.
Please note there is no co-payment applicable for the supply of CGM products through the NDSS.
Changing CGM Devices or Terminating Access through the NDSS
If you or you health professional decide to change CGM devices, or end access to CGM through the NDSS, the below form will need to be completed.
If changing device, the form must be certified by an authorised health professional.
If terminating access to CGM through the NDSS, the form can be completed by you or your health professional.
More Information and Links
You can find more information from the Department of Health by clicking here.
NDSS Access Points can find more information on our learning portal, ndssaccesspoints.learnupon.com.