Department of Pediatrics, Motol University Hospital, Prague, Czech Republic.
Department of Pediatrics, Medical University of Warsaw, Warsaw, Poland.
Pediatr Diabetes. 2019 Jun;20(4):434-443. doi: 10.1111/pedi.12833. Epub 2019 Apr 11.
Frequent use of modern diabetes technologies increases the chance for optimal type 1 diabetes (T1D) control. Limited reimbursement influences the access of patients with T1D to these modalities and could worsen their prognosis. We aimed to describe the situation of reimbursement for insulins, glucometers, insulin pumps (CSII) and continuous glucose monitoring (CGM) for children with T1D in European countries participating in the SWEET Project and to compare data from EU countries with data from our previous study in 2009.
The study was conducted between March 2017 and August 2017. First, we approached diabetes technology companies with a survey to map the reimbursement of insulins and diabetic devices. The data collected from these companies were then validated by members of the SWEET consortium.
We collected data from 29 European countries, whereas all types of insulins are mostly fully covered, heterogeneity was observed regarding the reimbursement of strips for glucometers (from 90 strips/month to no limit). CSII is readily available in 20 of 29 countries. Seven countries reported significant quota issues or obstacles for CSII prescription, and two countries had no CSII reimbursement. CGM is at least partially reimbursed in 17 of 29 countries. The comparison with the 2009 study showed an increasing availability of CSII and CGM across the EU.
Although innovative diabetes technology is available, a large proportion of children with T1D still do not benefit from it due to its limited reimbursement.
频繁使用现代糖尿病技术增加了实现 1 型糖尿病（T1D）最佳控制的机会。有限的报销会影响 T1D 患者获得这些治疗方式的机会，并可能使他们的预后恶化。我们旨在描述参与 SWEET 项目的欧洲国家中儿童 T1D 患者胰岛素、血糖仪、胰岛素泵（CSII）和连续血糖监测（CGM）报销的情况，并将欧盟国家的数据与我们 2009 年的研究数据进行比较。
该研究于 2017 年 3 月至 2017 年 8 月进行。首先，我们向糖尿病技术公司发送了一份调查，以绘制胰岛素和糖尿病设备的报销情况。然后，SWEET 联盟的成员验证了从这些公司收集的数据。
我们从 29 个欧洲国家收集了数据，虽然各种胰岛素大部分都得到了充分的覆盖，但血糖仪的试纸报销情况存在异质性（从每月 90 条到无限制）。29 个国家中有 20 个国家可以方便地使用 CSII。7 个国家报告了 CSII 处方的重大限额问题或障碍，2 个国家没有 CSII 报销。CGM 在 17 个国家至少部分报销。与 2009 年的研究相比，欧盟的 CSII 和 CGM 的可用性有所增加。
尽管有创新的糖尿病技术，但由于报销限制，很大一部分 T1D 儿童仍无法从中受益。
