I thank the Minister of State, Deputy Feighan, for coming here to discuss this all-important issue. Over 300,000 people in the State currently live with diabetes, including type 1 diabetes, and many of them are on continuous glucose monitoring, CGM. It has been absolutely life-changing for people. People can lead a very healthy lifestyle with it. They are able to monitor their glucose levels and can tell if they are high or low, and they are able to administer whatever is needed, be it insulin or another medication, to themselves depending on the results. Also, healthcare professionals can monitor patients’ glucose levels and outcomes, which is important, especially when patients are accessing their clinics. There are about 500 to 700 people who are not included in the CGM cohort. It is just that they may not have been insulin-dependent at the time of their diagnosis. That they do not have the machine is an oversight. I do not believe it was intentional; it was just that the patients were not insulin-dependent. Could the Minister for Health re-examine this and determine whether the 500 to 700 people who need to be included in the scheme can be included? If they can be, it will be life-changing. So many people are so dependent on monitoring their sugar levels. I look forward to the Minister of State’s answer.

I thank Senator Byrne for raising this important issue. I will be answering on behalf of the Minister for Health, Deputy Jennifer Carroll MacNeill.

The State acknowledges the importance of access to new and innovative medicines for patients and is acutely aware of the plight of patients diagnosed with diabetes. By way of background, CGM systems provide an alternative approach for self-monitoring of blood glucose. These CGM systems comprise sensors, transmitters and a mechanism to display results.

Under the Health Act 2007, HIQA has a statutory remit to evaluate the clinical and cost-effectiveness of health technologies and provide advice to the Minister for Health. HIQA conducts health technology assessments, HTAs, for programmes and services at the specific request of the HSE or the Department of Health, which may include medical devices.

The HSE has advised that HIQA’s rapid HTA of CGM in adults with type 1 diabetes mellitus was published on 29 September 2023. The HTA recommended the establishment of a single managed access programme for all CGM systems for all individuals with type 1 diabetes mellitus regardless of age, noting that such a system would need clearly defined criteria for access.

Following on from the recommendations in this HTA, the HSE medicines management programme, in conjunction with the HSE primary care reimbursement system and with the support of the HSE chief clinical officer, introduced an online reimbursement application system for all CGM sensors on 1 December 2023. At this point in time, reimbursement support for CGM sensors is based on the HIQA HTA. By the end of 2025, over 27,000 patients in Ireland were approved for reimbursement support for CGM sensors. To date, a HTA of CGM sensors for people with type 2 diabetes mellitus or other types of diabetes has not been undertaken in Ireland. Therefore, there is limited information to support the extension of reimbursement to these patient groups. Such information would include a cost-effectiveness assessment and the budget impact of the measure. The HSE has identified preferred CGM products based on cost effectiveness to manage this expenditure. A second review of CGM sensors is taking place, which will include an update of the preferred CGM sensors evaluation.

On 21 May, the Minister for Health launched Diabetes Policy and Services Review: A Strategy for Better Care. This is Ireland’s first national strategy for diabetes. It sets out recommendations for action in relation to type 1 diabetes, type 2 diabetes, diabetes in pregnancy and paediatric diabetes. The strategy marks a major milestone in diabetes care in Ireland, representing the development of a unified approach to the delivery of diabetes care.

I again thank Senator Byrne for raising this very important issue today. I will bring her views, concerns and ideas back to the Minister for Health, Deputy Carroll MacNeill.

I thank the Minister of State very much. It is wonderful that 27,000 people have been reimbursed. In the context of that 27,000, the figure of just over 500 who have fallen through the cracks is quite a small number. I request that the Minister carry out a review because these people, who are now insulin-dependent, should be included in the reimbursement programme. We have come a long way from the time when people had to prick their finger and test their blood to see what their levels were. It certainly has been life-changing. It is better for both those who have type 1 diabetes and those who have type 2. I certainly hope that review will lead to those who have type 2 diabetes, especially those at the higher end, being included.

I will bring the Senator's views to the attention of the Minister, Deputy Carroll MacNeill. I assure her that the Minister for Health really appreciates the importance of ensuring that patients with diabetes in Ireland have access to the latest treatments. The Minister for Health met Diabetes Ireland in April of this year and attended its conference in May. She has been made aware of the group's perspectives on access to CGM sensor technology. As the Senator has outlined, there has been a significant shift in the quality and delivery of diabetes care in recent years. More patients are provided with care in the community at an earlier age. Research into the chronic disease management programme has shown that over 90% of patients with chronic diseases, including diabetes, are now successfully managing their conditions in community settings. As I stated earlier, building on the national framework for integrated prevention, the Minister launched Diabetes Policy and Services Review: A Strategy for Better Care in May of this year. This policy-associated report was developed in collaboration between the Department of Health, the HSE and Diabetes Ireland. It is Ireland's first national strategy for diabetes. It marks a major milestone in diabetes care in Ireland, representing the development of a unified approach to the delivery of diabetes care.