HCL (Hybrid Closed Loop) News announcement

[BadaBing]

It is great news that Professor Kar and his colleagues have gotten this over the line. They deserves massive congratulations.

It is right that young people up to the age of 18 will, - if they want to - benefit from the new technology immediately with the only criteria being Type 1. Pregnant women or trying for pregnancy too.

Professor Kar has said repeatedly in webinars the NICE Technical Appraisal Document will be reviewed in 3-5 years and it is his hope hybrid closed loops will become standard care for all Type 1s eventually.

As for me, I wouldn't mind a patch pump hybrid closed loop. At the moment that means Omnipod 5. However, I understand from my diabetes team that in my health area the ICS/ICB won't even consider it until the expensive Omnipod 5 comes down in price and it integrates with less expensive continuous glucose monitors than the Dexcom G6 (or G7).

Has the NHS in England and Wales managed to negotiate a price centrally with Insulet for the Omnipod 5 that our taxpayer funded healthcare system can live with?

Reply

 

[helli]

As for me, I wouldn't mind a patch pump hybrid closed loop. At the moment that means Omnipod 5. However, I understand from my diabetes team that in my health area the ICS/ICB won't even consider it until the expensive Omnipod 5 comes down in price and it integrates with less expensive continuous glucose monitors than the Dexcom G6 (or G7).

What is your reason for desiring a patch pump?
I have used both patch and tubed pumps. Whilst my preference is patch, I would not rule out tubed again if it was the only way to get HCL.

However, OmniPod is not the only patch pump. I use Medtrum. This is very small and discrete. Today it is half HCL - it suspends my basal when going low but does not add any when I go high. They are trialling HCL in Netherlands which they hope to release in the new year.
Like yours, my clinic would not find OmniPod as they would rather spend their “pump budget” on more people. Medtrum is cheaper and the CGM is comparable price to Libre. Unfortunately, Medtrum CGM is not approved by my clinic so I have to self fund even though I am entitled to (and don’t use ) Libre on prescription.

 

[BadaBing]

What is your reason for desiring a patch pump?

Personal preference.

I have used both patch and tubed pumps. Whilst my preference is patch, I would not rule out tubed again if it was the only way to get HCL.

Noted. I prefer a patch pump.

However, OmniPod is not the only patch pump. I use Medtrum. This is very small and discrete. Today it is half HCL - it suspends my basal when going low but does not add any when I go high. They are trialling HCL in Netherlands which they hope to release in the new year.
Like yours, my clinic would not find OmniPod as they would rather spend their “pump budget” on more people. Medtrum is cheaper and the CGM is comparable price to Libre. Unfortunately, Medtrum CGM is not approved by my clinic so I have to self fund even though I am entitled to (and don’t use ) Libre on prescription.

At present the only patch pump my clinic supports is the Omnipod (albeit the older Omnipod Dash). I try to work within what my clinic is prepared to support.

The NICE document published this weak is silent about precisely what patch pumps will be on offer. Partha Kar is supposed to be doing a number of webinars/podcasts beginning on 15 November 2023 with a DSN Forum event, when he may be able to give (as he said in recent videos on Twitter and Facebook published in last 72 hours, he is the only one in the know) more clarity about exactly what pump choices will be available).

 

[Bruce Stephens]

The NICE document published this weak is silent about precisely what patch pumps will be on offer.

I wouldn't expect that document to say, but I think you're exactly right that we don't know yet. There's clearly been some agreements made and we'll find out about those in the next few weeks. I assume what's available will increase over time but it's also possible some might drop out (if they're not good enough, or too expensive, or if the manufacturer decides to withdraw).