More players race to map your glucose levels, but CGM prices still too high  

The biosensors are smaller and research is more accurate, but price continues to play spoil-sport in the adoption of continuous glucose monitor (CGM), a device that helps people read their sugar levels and manage their diabetes.

Recently, the United States Food and Drug Administration approved their first over-the-counter (OTC) CGM, Dexcom’s Stelo Glucose Biosensor System. But CGMs have been available OTC in India for at least three years. Experts and users are now calling for affordably priced, new generation CGMs in India, which is home to the second-largest number of people with diabetes.

Besides multinationals Abbott, Dexcom and Medtronic, for example, home-grown brands – Ultrahuman and Eyva - have begun to emerge.

Popular CGMs involve a coin-sized biosensor fixed to the upper-arm and a reader that continuously reads sugar levels in the fluid present below the skin, explains diabetologist Dr V Mohan. Companies continue to research wearables to read glucose levels, but have not succeeded, said Mohan. The USFDA recently warned on the risk of using smartwatches, rings, etc., that claim to measure blood sugar without piercing the skin.

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Biosensors are getting smaller, and research is more accurate, but remain unaffordable to many, said Mohan, Chairman, Dr Mohan’s Diabetes Specialities Centre.

Abbott’s FreeStyle Libre System costs about ₹11,000-odd (reader and biosensor). The sensor (about ₹5,000 odd) gives continuous readings for 14 days and analytics over a three-month period and is a recurring cost for the consumer. Abbott has been selling FreeStyle Libre OTC in more than 60 countries for a decade, including OTC in India (2020), a company spokesperson said. Industry insiders point to Dexcom’s product as “high class, but expensive”. Presently unavailable in India, a company spokesperson told businessline, Dexcom Stelo was to launch in US (summer 2024), and it was evaluating markets on “a case-by-case basis”.

Micro-manage

CGMs help micro-manage medicine doses, or map the impact of changed medication on glucose levels, explains David Chandy, Consultant Endocrinologist at Sir HN Reliance Foundation Hospital. Medtronic’s CGM, for example, has a sensor and transmitter that are linked to an insulin pump to deliver the required dose, he says, but at over ₹40,000 (for transmitter), it becomes unaffordable, he observed. A user added that the annual cost could run into lakhs.

Without getting into price specifics, a Medtronic spokesperson said there was a growing adoption of personal CGMs as users received continuous information, including trends that could be correlated with food, activity, medications, etc.

Next-gen CGMs

Newer generation CGMs are being launched globally, but not available in India, says Chandy, urging them to bring in these products, at affordable prices. Next-gen products can, for example, alert users on a dip in glucose levels, which is especially useful in children, he explains.

Bengaluru-headquartered UltraHuman’s CGM was launched in 2020. But at ₹7,000 for a biosensor, is the price inhibiting adoption? “We want to make health accessible,” said Mohit Kumar, Ultrahuman Founder and CEO, in an emailed response on his behalf. “As the adoption of CGMs expands and as more manufacturers venture into the CGM market, we can optimistically expect a decrease in prices over time...”

A recent technology approval for the mobile phone has allowed more people to adopt the Libre CGM, as readings could be mapped with a mobile phone application, says Chandy. While some chemists were unaware, a user said, she used the CGM with other available software, as the recurring cost of the sensor was high.

Last year, a non-invasive glucometer Eyva, that claimed to give six readings in 60 seconds, on user touch, was unveiled at ₹16,650, in India. The readings included blood glucose (no needle pricks), HbA1c, ECG, blood pressure, oxygen and heart rate. The gadget features included a free app providing daily, weekly, and monthly trends on the person’s lifestyle, reports said.

“It allows four users to monitor their vitals on the same device. The software subscription is being offered for free and the user only has to bear the one-time product cost,” according to a report in this paper.