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3.5 yrs with Animas; considering changing to Medtronic

Discussion in 'Parents of Children with Type 1' started by Jacob'sDad, Jul 12, 2011.

  1. Jacob'sDad

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    Hi all! So here's the deal:

    Jacob has been pumping with the Animas 2020 pump since 11/30/07.
    I have no complaints about the pump at all. We love Animas.

    Jacob also uses the Dexcom CGM. We have had issues, the main one being that he is allergic to the adhesive and all attempts to block the adhesive have fallen short. We also have issues with the Dex going ??? during the night when we need it the most. It also lacks accuracy for us during the first day or two and sometimes loses accuracy after that to an unacceptable level. So the use of the Dex is intermittent but I don't want it to be. I want him using a CGM full time.

    I have also been waiting for the Dexcom/Animas integration but if there is an adhesive allergy issue with the Dexcom, what's the point? He would STILL be allergic to the adhesive even after integration. Unless they change the adhesive. I doubt that will happen.

    So here's what I'm thinking:
    After 3.5 yrs we might be able to get insurance to pay for a new Medtronic Revel pump which is integrated with a CGM. He hopefully would not be allergic to that adhesive. I'm sure I could get Medtronic to send sample sites to see how his skin reacts.

    Does this sound like a reasonable step to take?
    Does anyone know what the cost would be for a Revel pump if insurance pays 80%? See that's a factor too; we can't make the change if we can't afford it. Of course Medtronic will run it through insurance and let us know what the cost would be; I'm just curious as to ABOUT what we could expect to pay.

    Thanks for reading the long post. Any comments will be appreciated.:):cwds:
     
  2. momofsingingdiabetic

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    We upgraded Danielle's in March and this is what we had (insurance pays 80%).

    With a $500 trade in for her Ping the pump itself (with 3 months supplies) was approximately $1234. With CGMS added (and 3 months sensors) it was approximately $1615. This includes our $500 deductible.

    We just got the CGMS part about 2 weeks ago. We had to appeal to get it covered. It's funny because I got the EOB today for the Transmitter and the $500 deductible was added on that. I still have not seen an EOB for the pump itself. Oh, and they set us up on a payment plan too. Spread it out over 35 months....but I've not yet seen a bill for it either.
     
  3. Nancy in VA

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    I can't speak about the cost issues, but the transmitter for the Medtronic is different. This isn't really much "adhesive" like you have with the Dex or Nav. What you are going to have is the clamshell, which may or may not even have a little adhesive on the back of it, and hte senstor inserted with no adhesive - the adhesive you use is what you apply yourself, basically. So, if you have identified an adhesive that works for you and an overbandage, the Medtronic should be ok for you. We only trialed it for two different 1 week periods, but I don't remember any specific adhesive on the transmitter or the way the sensor inserted - just the IV3000 we put over it
     
  4. Lee

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    Hey Dave, long time no see!

    We just upgraded to the Revel and I have to say I love it. The sensor, when I can get her to wear it, has predictor alerts - which she loves to use.

    I think at 3.5 years, allergy to adhesives is a great reason to switch. We upgraded because of her low unawareness.

    I also think that if you aren't using the remote with the Animas Ping, the integrated CGMS is a big plus! Also, talk to Kim - FLutterby - her daughter has had some pretty bad adhesive allergies.
     
  5. momofsingingdiabetic

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    The transmitter has no adhesive, but the sensor has a small amount. We cover with IV3000 or similar just to keep it from coming off. The connection between the transmitter and the sensor is water-tight (so they tell us).
     
  6. Lee

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    Just don't disconnect it when it is wet, because then water gets into the transmitter and kills it - go ahead, ask us how we know :rolleyes:!
     
  7. dianas

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    Does your endo do I-Pro studies? Or could you get a trial of the CGMS through Medtronic or your endo? If so that would be a way of trialing Medtronic's CGMS sensors before switching. The I-Pro would be a blinded sensor rather than real time but you'd still have a chance to see how his skin would react.
     
  8. sarahconnormom

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    We just upgraded to the Revel 723 in April. We originally had the MM 522 but had only had it for 3 years so we had to convince insurance to let us get a new pump a year early. With a letter of medical necessity from our endo they paid for it.

    Our insurance covers the pump at 80% and we pay 20% of the contracted cost. Our total bill for the Revel 723 pump, the CGM, and one box of sensors is $706.00. Our cost on the pump alone is $599, the other $107 is the CGM and sensors.

    Hope that helps.
     
  9. Flutterby

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    HI Dave, we did get insurance to cover the revel before current pump was up for warranty. It really didn't take much, although it really was a surprise.. The MM rep called our insurance company and they said it wouldn't be covered simply because if there is an issue it is to be replaced through MM.. We submitted the paperwork, along with logs and the reason for wanting the revel (the smaller basal/bolus capabilities). Her endo also wrote a letter of medical necessity, and basically the MM rep said you pay for it now, or in a few months.. I got an EOB in the mail saying the pump was covered.. huge surprise, a nice surprise!

    As for adhesive issue.. we've had major problems and its one (of the many) reasons why I like the MM minilink over the dex cgms. *I* can choose what adhesive to use. Kaylee's seen a specialist to get the adhesive issues worked out, sense then we've had very few problems. We do specific things at each sensors change but the major things is we use paper tape, J&J tough pads and hypafix... we also make sure that we use a adhesive remover, wash it was soap and water (whether there is visible adhesive left on her skin or not) and then cover with cortizone cream.

    If you would like our routine in detail just let me know, you can PM me or I can put it here.. its late and I'm tired so I'm not going to type it out right now. ;)

    Also, this time our insurance only covered 80% (first time it was 90%).. I believe our left over was $1,000 but we had backup insurance at the time that took care of all of our copays. Also, I'm not sure if you are aware of this but MM will make a payment plan for you. I know when we purchased her first pump we had $750 left over, we did payments of $50.00 a month (I believe that is the lowest they'll except) until it was paid off.. so if you owe a grand or whatever, they will work with you to make sure you can afford the pump, their goal is to get the pump to a child and not let copays stand in the way.

    I'm not sure if you are aware but MM has two different sizes the 5 series and the 7 series.. or 523 and 723.. the 523 has a reseveroir that hold about 180u and the 723 holds 300units, both are called the 'revel'.. This is a good angle to use with the insurance company, at Jacobs age he may be needing more than the 180/200u that animas reseveroir holds every 3 days.. so you could use the fact that MM's revel holds more insulin could really play in your favor.

    Good luck!
     
  10. SarahKelly

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    we tried out the MM sensor before trying the pump even, we did the 3 day with the endo so they could have a "look" at what was going on, but truly it was to see which pump we would choose. I preferred an integrated one for such a small child and knew that if the sensor worked we'd be happy with the pump too as I'd played around with one a while before that. So, sensor slapped on, no issues with the adhesive and we were signed up within a week to start pumping. I can't remember what the price was to start up, but I think $800 for the pump and $800 for the CGM (three month supply and transmitter). We've had great trainers willing to even come to our home, which is very helpful with such young kiddos.
    I will have to be honest though that over time Isaac has developed a bit of an intolerance to the adhesive, it seems that for him this happens every so often so we have to switch things up and keep a variety of different tapes, sites, and lotions on hand to make sure things heal properly and aren't getting over used. It has been trouble for us though with pump sites, too not just CGM.
    Hope that helps a bit :)
     
  11. Lize

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    My DD has a huge allergic reaction with any adhesive. We held thumbs that with the new Enlite Sensor, it would be different. After 2 days on her tummy, we had to pull the new sensor as well. She scrathes herself untill the blood comes out. With the old sensor we used to put Hypafix over and only on her thigh she showed no allergic reaction. We now do this with the MM Enlite Sensor as well.

    I hope it will be different for you. At least it works on her thigh. And the accuracy is really, really good there.
     
  12. hawkeyegirl

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    I wanted to add that if you do end up ordering a Revel, ask for the Guardian unit too. That way you get integration AND a separate receiver for you to look at. It's really handy. :)

    Oh, and I just checked. We have plenty of sensors. If you want me to send you one, I will. You could cut the tape off and stick it on him and see if he reacts.
     
  13. Jacob'sDad

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    Sorry I haven't been on to respond, but thanks for all the great advice and information, everyone!:)

    I have a business card for a Medtronic rep, so I will give her a call. Jacob's next Endo appt is in Sept, so probably nothing will change until after that.

    I'm sure his Endo will be willing to give any medical necessity papers I request. Definitely the cartridge size of the 722 will come into play. Our insurance is pretty good and I don't foresee any issues, but you never know.

    So we have to apply adhesive under the site? Jeez I think Jacob has reacted badly to Skin Tac and Mastisol. Mastisol for sure. He does not break out from pump sites.

    How about the probe length? It's pretty long isn't it?
     
  14. hawkeyegirl

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    We put a piece of Opsite under the transmitter, but don't use SkinTac or anything like that. Just another piece of tape over the sensor and transmitter.

    The needle length is the exact same length as Dexcom. Not sure how the actual sensor length compares.
     
  15. momofsingingdiabetic

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    Danielle doesn't put any adhesive under the sensor....just uses what is attached to it then covers it so it doesn't get caught and pull out. Not really sure how long the probe length is. It doesn't seem to bother her any though.
     
  16. denise3099

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    I can send you a sensor just so you can stick it on to check for a reaction (remove needle of course). I pm'd you.
     
  17. Flutterby

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    I use tough pads under the transmitter.. nothing under the sensor.. you aren't suppose to use anything but alcohol where the actual sensor is going to be anyway.

    I've delt with nasty, harsh reactions, we've figure out a way to make it work.. I did not want to give up the sensor! :)
     
  18. Little Diabetic Dude

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    I live in AUstralia and we have a 3 1/2 yr old on Medtronic Veo and have tried CGM's not good price wise for us and very difficult to manage overall we trialled it for a little while I found it more trouble than I thought it was beneficial.
    Medtronic has been good for us, easy to use and ours is fully covered by our healthy fund. Maybe you should ask for a trial for both cgm and pump.
     
  19. TracieandJim

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    Dave we have been considering a switch also. Samuel's pump warranty will be expired sometime next year. Amazing how time flies! He also gets a rash from the adhesives but it's very infrequent and mostly from the bandaids covering old sites. Good luck with the insurance company.:)
     
  20. Jacob'sDad

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    OK, so what's this I'm reading about spontaneous restarts with a Medtronic CGM?

    Is that going to be an issue we will have to deal with? If the change is going to be more headaches than it's worth, I probably won't do it.

    Right now Jacob has a Dex site in and his skin is fine. It's day four. There is liquid bandage under the site and nothing else.

    I don't dislike Animas at all (other than the forever wait for integration) and I have a love/hate relationship with Dexcom. I don't want to rush into a change thinking there will be no issues and then find out there are issues that are as bad as what we are dealing with now.

    So, so far I have said that Jacob has an allergy problem with the Dex adhesive. But what other issues might pop up if we make the change to Medtronic?
     

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