Diabetes tech firms Dexcom and Abbott are watching closely for a Medicare coverage expansion that could significantly broaden access to their glucose sensors.
The Centers for Medicare and Medicaid Services is expected to expand Medicare coverage of continuous glucose monitors to people with diabetes who do not take insulin. Currently, coverage is limited to people with Type 1 or Type 2 diabetes who take insulin or have a history of problematic low blood sugar.
Dexcom CEO Jake Leach told investors in a late July earnings call that the company expects to hear back from the CMS before the end of the year, with coverage going into effect in mid-2027.
Dexcom estimates roughly 25 million people in the U.S. have Type 2 diabetes and don’t take insulin. Roughly half of this group is of Medicare age, Leach said, giving the decision “the potential to completely reshape diabetes care in the U.S.”
Dexcom presented results of a randomized, controlled trial earlier this summer at the American Diabetes Association’s Scientific Sessions that it expects will support the CMS’ decision. The 26-week study found that people who used a CGM had a larger hemoglobin A1C reduction than the control group and spent five more hours per day in a normal glucose range than the control group.
Competitor Abbott also sees an opportunity with the planned coverage expansion. CEO Robert Ford told investors in the company’s July earnings call that Abbott expects the U.S. Type 2 expansion to make about 10 million more Medicare recipients eligible and expand commercial insurance coverage. The company is preparing its sales force, distribution and other resources to be able to make the most of the chance, Ford said.
“This could be a multibillion-dollar opportunity, and it could happen in the fall,” Ford said. “I just can't forecast … when exactly it's going to happen.”
Dexcom reported second-quarter sales of $1.31 billion, a 13% increase year over year. Abbott’s diabetes care sales in the quarter were $2.19 billion, a 10.5% increase.
