UnitedHealthcare partnered with Medtronic Feb. 1 to make the device company’s MiniMed 670G insulin pump system its preferred pump for diabetics aged 7 and up—a move the Juvenile Diabetes Research Foundation (JDRF) calls “an unacceptable step backward” and says effectively limits patients’ choices to one product.
According to a statement, UnitedHealthcare, the largest insurer in the U.S., reached its agreement with Medtronic shortly after the FDA expanded approval for the MiniMed system, extending its benefits to patients as young as 7 years old. The company cited a “rigorous body of clinical trial and real-world data” as the reason it selected the MiniMed as its preferred pump, which means the device will be the only one covered under network plans unless patients obtain an exception.
In the company’s February 2019 bulletin, UnitedHealthcare representatives assured enrollees there will be no change in coverage for members currently using an insulin pump and receiving supplies. Existing pediatric patients using a non-Medtronic pump will be able to remain on that pump in conjunction with their treatment plan, but new members and those receiving a prescription for an insulin pump for the first time will be referred to the MiniMed system.
“Exclusive agreements are bad for people with type 1 diabetes, bad for our healthcare system and bad for innovation,” JDRF, a diabetes advocacy group, wrote in a statement published Feb. 4. “When a medical device manufacturer enters into agreements with insurers, they have little incentive to innovate and develop new treatments, making it even harder to manage what is already a challenging disease.”
JDRF pointed out that just like diabetes isn’t one-size-fits-all, neither are pumps. Different ones work for different people, and nearly half of patients who stopped using an insulin pump within a year of prescription did so because they said it didn’t fit their lifestyle.
“This makes sense,” the group wrote. “It’s a personal decision that directly affects how people manage their type 1 diabetes, and so it should be them, and their healthcare team, who make this decision—not their insurance company.”
The foundation said UnitedHealthcare’s decision limits patients to one brand of pump with minimal exceptions, meaning if a patient prefers a different brand they have to finance their care out-of-pocket.
According to UnitedHealthcare’s bulletin, the change won’t affect non-durable insulin pumps, like tubeless pumps. The insurer said it will continue its clinical review process for prescribing physicians and members who think they’d prefer a device other than the MiniMed.