Blood Glucose Test Strip Dosing Limit with Continuous Glucose Monitors (CGM)

Oct 20, 2023

Effective October 1, 2023, a maximum of 100 blood glucose test strips will be available every 90 days without Prior Authorization for members utilizing CGM.  

Earlier this year, we completed a retro-drug utilization review (DUR) analysis comparing member blood glucose test strip usage before and after starting CGM. Unexpectedly, member test strip utilization did not decline after starting a CGM with some members continuing to utilize 10-12 strips per day. This contrasts with 90% reduction in test strip usage reported in two clinical studies, IMPACT1 and REPLACE2.  These studies demonstrated a decrease in test strip utilization, reduced hypoglycemia and no device related serious adverse events.     

For questions, please contact the Change Healthcare Pharmacy Help Desk at 1-888-420-9711 or via email.