Description of Medical ServiceThe CGM Initiative commenced on 1 April 2017 and provides fully-subsidised access to CGM products (no patient co-payment required) to eligible people through the National Diabetes Services Scheme (NDSS). Approximately 58,000 patients are eligible to access CGM products through CGM initiative.
Under the expanded eligibility criteria introduced from 1 March 2020, CGM products are provided to:
- children and young people, under 21 years of age, with type 1 diabetes;
- children and young people with conditions very similar to type 1 diabetes, such as cystic fibrosis related diabetes and neonatal-onset diabetes, who require insulin;
- women with type 1 diabetes who are planning for pregnancy, pregnant or immediately post-pregnancy; and
- people with type 1 diabetes aged 21 years or older who have concessional status.
Description of Medical ConditionType 1 diabetes is an auto-immune disease where the body's immune system attacks the insulin-producing cells of the pancreas. People with type 1 diabetes cannot produce insulin and require lifelong insulin replacement to survive. The disease can occur at any age, although it mostly occurs in children and young adults.
Reason for ApplicationOn 6 November 2020, the Department of Health announced a Review of CGM Products provided through the CGM Initiative will be conducted and evaluated by the Medical Services Advisory Committee (MSAC) to ensure government-funding of CGM products used in Australia is based on strong evidence of clinical and cost effectiveness. The Review will include currently subsidised CGM products, and CGM products for which subsidisation under the initiative is being sought. The Review is consistent with the periodic reviews of publically funded pharmaceuticals and medical technologies that are undertaken by the Department.
Learn more about the Review of CGM Products, including the Terms of Reference and how to make a submission.