Ontario Public Drug Programs
New limits on reimbursement levels for Blood Glucose Test Strips
Research has indicated that Blood Glucose Test Strips (BGTS) have a limited benefit for many patients who do not take insulin to manage their diabetes. Based on best evidence, the government is introducing changes to the number of blood glucose test strips it will reimburse people with diabetes, while ensuring those who need test strips to help manage diabetes will continue to have access to them. The new changes are effective August 1, 2013, and are aligned with the Canadian Diabetes Association (CDA) for encouraging proper testing practices for optimal patient outcomes.
A July 2009, report from Canadian Agency for Drugs and Technologies in Health (CADTH) stated that blood glucose test strips, in practice, have a limited clinical benefit for many patients who are not on insulin. The CDA also published a commentary recognizing that some limits on the number of blood glucose test strips reimbursed for patients on oral anti-diabetes medications may be reasonable.
Test Strip Reimbursement Limits
To help monitor the number of test strips your patient has received during a 365-day period, the ministry's Health Network System (HNS) will track and determine the reimbursement level based on each patient's diabetes treatment. For more information on the HNS and your role, please visit our question and answer page.
The chart below shows the reimbursement limits for test strips for each 365-day period:
|Diabetes Treatment Category||Number of BGTS allowed within a 365-day period|
|Patients managing diabetes with insulin||3,000|
|Patients managing diabetes with anti-diabetes medication with high risk of causing hypoglycemia||400|
|Patients managing diabetes using anti-diabetes medication with low risk of causing hypoglycemia||200|
|Patients managing diabetes through diet/lifestyle therapy only (no insulin or anti-diabetes medications)||200|
We need your help
We need your help to ensure that each patient receives the correct number of strips and to help answer any questions they may have on the new limits. We're asking that you discuss the new limits with your patients and speak to them about proper testing practices and frequency of testing that's right for them.
Printable documents for sharing with your patients are available here:
- Tear Pad – reimbursement levels and where to find information on managing diabetes
- Questions and Answers for your patients
- Testing for a Reason: A Guide for You. New Information About Type 2 Diabetes and Testing Your Blood Sugar
Information for health care professionals:
If your patient is using prescription medication as part of their diabetes treatment plan, we also ask that you remind your patient of the free annual MedsCheck consultation for diabetes with their community pharmacist.
We thank you for continuing to help your patients manage their diabetes and your ongoing commitment to keeping Ontarians healthy.
If you need more information on the new reimbursement levels for your patients using blood glucose test strips, please contact Service Ontario at 416-326-1234 or 1-800-267-8097 (toll-free)
If you want more information on the latest from the Ontario Ministry of Health and Long-Term Care, including diabetes newsletters and other downloadable resources, please visit Stand Up to Diabetes
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