Freestyle Libre vs Dexcom G6
Which Continuous Glucose Monitor (CGM) is better?
There are multiple studies that have come out supporting the theory that continuous glucose monitoring is generally superior to traditional blood glucose monitors. The most novel CGMs can measure glucose levels as often as every minute and easily detect highs and lows. Companies making these products claim that if they are properly used, they can prevent hospitalization as well as make it easier for providers to change treatment when needed. But is there a superior CGM?
Freestyle Libre 14 Day System
The System: The Freestyle Libre 14 Day System comes equipped with a handheld reader and a disposable sensor that is to be inserted on the back of the upper arm. The reader is used to scan the sensor and get the glucose readings wirelessly, but it will only read if they are less than 1.5 inches apart. The reader and sensor kit are sold separately and require a prescription from a doctor. The sensor kit includes one sensor that lasts for an average of 14 days. When changing sensors, the new sensor takes about an hour to warm up and start measuring levels. The interstitial fluid glucose concentrations are measured every minute and stored within the sensor every 15 minutes. There are no alerts for highs or lows and the user must scan the sensor for each reading.
Key Features: The Freestyle Libre sensor is small and easy to insert. The reader can be used as a traditional blood glucose monitor with Freestyle Precision Neo Test Strips. There is an app that can be used with compatible devices for the readings named Freestyle LibreLink. Also, both the reader and the sensor do not require calibration.
Out-of-Pocket Pricing and Insurance Coverage: The Freestyle Libre Reader Kit out-of-pocket price average is $130, and the Sensor Kit containing one sensor costs an average of $85. The system is not currently covered by insurances. There are online coupons that promise up to 80% off and some insurances allow patients to use their FSA accounts for payment.
Dexcom G6 CGM System
The System: Dexcom G6 CGM Starter System includes an auto applicator, a sensor, a transmitter, and a display device. The sensor must be changed every 10 days and can be inserted on the belly or upper buttocks. Each transmitter lasts for about three months. The transmitter continuously sends the glucose levels readings to the receiver or a device equipped with the app every 5 minutes. When changing sensors the user must enter a unique sensor code located on the sensor’s adhesive label and wait for 2 hours for the warmup.
Key Features: The Dexcom G6 sensor is a little larger than the Freestyle Libre but equally easy to apply. Users can set up alerts for highs and lows through the app or receiver. In addition, the company offers an app for providers making it easy for patients to share their information with their doctors when needed.
Out-of-Pocket Pricing and Insurance Coverage: The starter kit out-of-pocket price has an average of $1,200. A box of sensors containing 3 sensors for a month supply costs around $350. And a box of transmitters containing 2 transmitters for a six-month supply averages at $475. Purchasing only the sensors and the transmitters is an option as long as the user has a device that is compatible with the Dexcom app. With the proper documentation, some insurances are starting to cover the system and supplies, including Medicare. There are online coupons that can be used, but most likely will not take more than 20% from the out-of-pocket price.
Conclusion
CGMs are revolutionary and can have a positive impact in the treatment of type I and II diabetes. These devices have proven to be most beneficial when used by insulin-dependent patients. Both products described in this article have their pros and cons. Freestyle Libre is considerably cheaper but is not currently covered by insurances. The Dexcom G6 is very expensive but can potentially be covered by certain insurances. They are both equally easy to insert and their accuracy is comparable. My professional opinion is that if the patient is at high risk for hypoglycemic events, the Dexcom is a better choice due to the alerts feature. As healthcare professionals it is important to be informed about these devices and help our patients choose which device is most appropriate for them.
