To better understand the barriers to access to diabetes self-monitoring devices, the ACCISS Study, together with FIND, the global alliance for diagnostics, commissioned a report by the Clinton Health Access Initiative (CHAI) that outlined the current issues with access to self-monitoring devices.
Self-monitoring of blood glucose is an essential aspect to diabetes care for people with type 1 diabetes, and for many with type 2 diabetes, particularly those who use insulin. The glucose monitoring device market is made up on two main types of systems (referred to here as devices): self-monitoring blood glucose (SMBG) devices (which prick the skin, with blood then applied to a test strip that is inserted and read by a portable meter), and continuous glucose monitoring devices (CGM) (a sensor under skin takes readings that are transmitted to a reader or smartphone that shows levels every 1-5 minutes and displays trends). The market is fast-growing and worth over $US10 billion. Despite this growth, access to these devices, particularly in low- and middle-income countries (LMICs), is still a challenge.
No one intervention is sufficient as a standalone solution to overcome access barriers. We, therefore, propose several recommendations at the international and national levels to address these challenges, including: (1) Advocating for bilateral donor support for glucose self-monitoring; (2) Developing a Target Product Profile for devices appropriate for LMIC settings; (3) Improving market transparency, both on the demand and supply side; (4) Establishing access price agreements with suppliers; (5) Exploring alternative procurement channels such as coordinated procurement across multiple LMICs; (6) Including glucose self-monitoring devices in National Health Insurance (NHI) plans; (7) Strengthening overall diabetes care in LMICs; and (8) Conducting additional research to fill key evidence gaps.
We posit that these actions are an essential step to meaningfully shape the glucose self-monitoring device market and significantly improve health outcomes for people living with diabetes in LMICs.
To support this report, we have also produced a fact sheet with all the key findings. Download the fact sheet.