Cost of Eversense CGM System
The provided evidence does not contain specific pricing information for the Eversense continuous glucose monitoring system. However, I can provide context about CGM costs and coverage based on the available evidence.
What We Know About Eversense
The Eversense system is a long-term implantable CGM that requires a minor surgical procedure for insertion and has FDA approval for use with automated insulin delivery systems, but specific cost data is not available in the current evidence. 1
- The next-generation Eversense system demonstrated sustained accuracy up to 180 days with 92.9% of readings within 20% of reference values and an overall MARD of 9.1% 2
- The modified sensor (sacrificial boronic acid version) showed even better performance with 93.9% accuracy and 8.5% MARD, with 90% sensor survival to 180 days 2
- No device- or insertion/removal procedure-related serious adverse events were reported in the PROMISE study 2
General CGM Cost Context
CGM systems are noted as "relatively expensive" in clinical guidelines, though specific dollar amounts vary by system and are not provided for Eversense in the available evidence. 3
Comparative Cost Information Available:
- Real-time CGM systems generally have higher direct costs than intermittently scanned CGM (flash monitoring) systems 3
- The Dexcom G6/G7 and FreeStyle Libre systems have achieved broad insurance coverage including Medicare eligibility, making them the most accessible CGM options 1
- Cost-effectiveness studies show CGM can be cost-effective at willingness-to-pay thresholds of $100,000 per quality-adjusted life-year in adults with type 1 diabetes on multiple daily injections 4
Insurance Coverage Considerations
Alternative systems like Eversense may have different coverage patterns compared to Dexcom or FreeStyle Libre due to the required minor surgical procedure for implantation. 1
- Medicare requires documentation that CGM continuously measured glucose and displayed data in real-time >95% of the time for ongoing coverage 1
- Most commercial insurance carriers cover factory-calibrated systems like Dexcom G6/G7 and FreeStyle Libre 1
- Coverage decisions should be based on thorough evaluation of patient characteristics, needs, and device availability through shared decision-making 3
Clinical Value Proposition
- The 180-day wear time of Eversense potentially reduces the frequency of sensor replacements compared to 10-14 day systems 2
- Long-term implantable systems may offer advantages for patients who have difficulty with frequent sensor changes or skin reactions to adhesives 2
- CGM use in general has been shown to reduce healthcare costs by averting severe hypoglycemic events requiring hospitalization, with estimated savings of $946-$1,346 per high-risk patient annually 5
Practical Recommendation
For specific Eversense pricing, contact the manufacturer (Senseonics) directly or consult with your local durable medical equipment supplier, as costs vary by insurance coverage, geographic location, and whether the system is covered under pharmacy or medical benefits. The surgical insertion requirement may affect both the total cost and insurance coverage pathway compared to transcutaneous CGM systems.