IES2025 Research, Audit and Quality Improvement Projects Physical Posters (55 abstracts)
Department of Endocrinology and Diabetes Mellitus, St Vincents University Hospital, Dublin
Annual expenditure on Continuous Glucose Monitors (CGM) increased from C=18.8 to C=55.72 million between 2021-2023. The HSE Reimbursement Application System, launched in December 2023, restricts new CGM access to type 1 diabetes mellitus only. Guidance regarding preferred CGM systems was published in July 2024 following evaluation by the Medicines Management Programme (MMP). Failure to implement recommendations risks continued restricted access to CGM for all individuals living with diabetes. We sought to simplify the MMP guidance aiming to increase adherence and demonstrate significant cost savings. We developed a prescribing support tool and audited adherence across outpatient attendances in May 2025. Data collected includes subtype of diabetes, CGM prescription status pre and post attendance, and the prescribers rationale for deviation from MMP guidance. Cost saving analysis was completed based on annual total cost saving for all those transitioned to preferred CGM system within this 30 day period. Data is available for 174 of 220 outpatient attendances. 70 insulin pen users were prescribed CGM, 16 of whom were prescribed a preferred CGM system at baseline. From the remaining 54 eligible individuals, 10 were transitioned to a preferred CGM system following their outpatient review (18.5%). The total annual cost saving generated by these 10 changes was C=13,329.80. The most common rationale provided for deviation from MMP guidance related to prevention, management or monitoring of hypoglycaemia. This suggests supported implementation of the MMP Guidance is associated with modest cost savings in practice due to perceived clinical benefit from advanced features available only with non-preferred sensors.