Book about noninvasive glucose meters

December 12, 2016

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Noninvasive glucose meters are the Holy Grail in glucose testing. To be able to get a glucose value without a finger stick would be a tremendous benefit to the millions of people who have to test themselves several times each day.

So there have scores of scientists who have worked on the problem, backed by diagnostic companies since the profit potential is huge.

I remember while at Ciba Corning, attending a lecture on near infrared spectroscopy given by a professor whom I think we were supporting to try to come up with a noninvasive glucose meter.

On a website devoted to diabetes, I became aware of a book which chronicles the quest for a noninvasive glucose meter. It is recent (2015 publication date), free, and written by a former chief scientific officer and VP of LifeScan who has been involved in this search for years.

I found it fascinating.

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Test error and healthcare costs

December 7, 2016

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Conventional wisdom says that regulatory authorities approve assays that have the highest quality, meaning that the errors are small enough that no or little harm will arise because a clinician makes a wrong medical decision based on test error.

It is also true, although not talked about, that in most countries healthcare is rationed – the cost of treating everyone with every possible treatment is too high.

So here’s a hypothetical example using glucose meters.

First, we start out with the status quo for existing glucose meter quality and assume that on average, across all tests there will be some harm due to glucose meter error. The percentage of tests that harm people is unknown as is the range of harm but assume that these can be ascertained and do occur.

As for the hypothetical part…

There are 2 new glucose meters seeking approval

Meter A costs 100 times as much as current meters and is guaranteed to have zero error, as it is a breakthrough technology. Its use will reduce patient harm due to test error to zero.

Meter B costs 100 times less than current meters but isn’t quite as accurate or reliable. Patient harm will increase with the use of meter B.

If meter A is approved, because of healthcare rationing, costs will have to be transferred from other parts of healthcare to pay for meter A.

If meter B is approved, costs can be transferred from glucose meter testing to other parts of healthcare.

The point is not to try to answer whether meter A or meter B should be approved, but to illustrate that the cost issues associated with healthcare policy always exist but are rarely discussed.