Consumers with insulin-dependent diabetes are familiar with the dangers of uncontrolled levels of blood sugar. Those whose levels get too low can experience symptoms ranging from blurry vision and dizziness to loss of consciousness, seizure or coma. Those whose levels get too high may require hospital treatment to replace fluids and electrolytes.

Self-management of blood sugar levels using testing strips is therefore an important component of diabetes management for consumers with diabetes on insulin therapy. ^1-2

However, the accumulation of out-of-pocket expenses such as copays, deductibles or coinsurance may sometimes serve as a barrier for regular blood sugar monitoring.³

Many Anthem health plans offer programs that offer greatly reduced or no out-of-pocket costs for diabetes test strips for consumers.

A recent a study published in the American Journal of Managed Care demonstrated that lowering the cost sharing for blood sugar testing strips can both address this barrier and result in better rates of blood sugar control.⁴

HealthCore, the health outcomes research subsidiary of Anthem, Inc., conducted the first large scale study to use medical and pharmacy claims data integrated with blood sugar laboratory test results to evaluate the relationship between cost sharing for diabetic testing strips and blood sugar levels among consumers using insulin therapy.

Researchers found consumers with lower cost sharing were more likely to achieve blood sugar control:  achieving blood sugar control 58 percent of the time versus 50 percent for those with high cost sharing.

Despite filling more testing strips than consumers with high cost sharing, those with low cost sharing had lower total out of pocket costs. Consumers in the low cost sharing group paid 89 dollars per year in out of pocket costs compared to consumers in the high cost sharing group who paid 225 dollars. Additionally, the average health plan paid 1,058 dollars per year per consumer in the low cost sharing group compared to 439 dollars per year per consumer in the high cost sharing group.

Given these results and the benefits of blood sugar control in consumers with diabetes, health plans and employers may want to consider placing testing strips in lower cost sharing tiers and include monitoring of testing strip fills as part of the care management process for consumers with diabetes on insulin therapy.

¹Saudek CD, Derr RL, Kalyani RR. Assessing glycemia in diabetes using self-monitoring blood glucose and hemoglobin A1c. JAMA. 2006;295(14):1688-1697. doi: 10.1001/jama.295.14.1688.

²Malanda UL, Bot SD, Nijpels G. Self-monitoring of blood glucose in noninsulin-using type 2 diabetic patients: it is time to face the evidence. Diabetes Care. 2013;36(1):176-178. doi: 10.2337/dc12-0831.

³Karter AJ, Parker MM, Moffet HH, et al. Effect of cost-sharing changes on self-monitoring of blood glucose. Am J Manag Care. 2007;13(7):408-416.

⁴Agiro A, Xie Y, et al. Leveraging Benefit Design for Better Diabetes Self-Management and A1C Control. Am J Manag Care. 2018 Feb 1;24(2):e30-e36.