glucose test strip in use
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Although many people with diabetes use continuous glucose monitors (CGMs) to track their blood sugar levels, most still rely on traditional fingerstick glucose meters and test strips.

People spend a lot of money to use these essential tools and often have questions about the real value they are getting.

  • What do fingerstick tests tell us about diabetes management?
  • How accurate are the results?
  • Why are they so expensive?

While the high cost of insulin is getting media attention these days, these other vital supplies are a big financial burden as well. Research from 2012 shows that about 27% of diabetes-related expenses at pharmacies are for self-monitoring blood sugar, including meters and test strips.

In fact, more than 38% of those with diabetes in the United States (and 33% around the world) have rationed blood glucose testing supplies, according to a 2018 survey by T1International.

We took a deep dive into the questions about the high costs and comparative accuracy of the test strips.

Let’s start with the basics: Blood glucose meters and the test strips they require allow you to measure and monitor blood sugar levels at home and on the road. First developed in 1965 and used in doctors’ offices, meters and test strips became available at home in 1980.

To take a blood sugar reading, insert the strip into the meter and apply a drop of blood after using the needle to poke your finger. Most meters produce a reading within seconds. The meter can store that data for later review by you and your doctor.

Meters and strips are now an essential part of diabetes management for most folks with diabetes. That includes more than 30% of people with type 1 diabetes who now use CGMs, yet still do fingerstick tests to calibrate (reset the accuracy of) their monitors.

The FDA does not require backup fingerstick tests with some newer CGM systems.

If you have diabetes, you can do this: You stick the test strip into the meter, draw out a drop of blood, and transfer it to the edge of the test strip.

Even though the technology might seem old-fashioned, what happens next is pretty ingenious.

  1. The strip reacts with a substance to create an electric current.
  2. The electrons travel to the meter.
  3. The meter can tell you how much electricity was needed.
  4. Your bloodglucose number is displayed on the screen.

The science behind test strips is quite complicated. They are made up of at least five layers, including a super thin layer of gold that helps conduct the current. Click here to see an illustration.

Some brands of meters and strips appear to be more accurate than others.

There is concern about the accuracy of models that have been on the market for a long time and have not been tested for accuracy since their original approval by the FDA.

The California-based nonprofit Diabetes Technology Society (DTS) tested 18 popular blood glucose meters and compared their results to those of outside laboratories that tested the same blood specimens.

The gold standard of the DTS is that a meter and test strips should give a bloodglucose reading within 15% or 15 percent of the laboratory values at least 85% of the time.

Only six brands passed the accuracy test.

  • The next product from Bayer is the Contour.
  • Accu-Chek is from the same company.
  • Walmart ReliOn confirm from Arkray is 97 percent.
  • The Advanced from Agamatrix is 98%.
  • FreeStyle lite from Abbott is 98%.
  • Accu-Chek Smart View from Roche is 95 percent.

There are a lot of test strips and meters that are not accurate. Some of the most accurate were:

  • The second Solus V2 from Bio Sense Medical is 76%.
  • Advocate Redi-Code+ from the Diabetic Supply of Suncoast.
  • Gmate Smart was from Philosys.

Still, according to experts in the Journal of Diabetes Science and Technology, when choosing a glucose meter, you should consider the accuracy of results as well as:

  • It is easy to use.
  • Maintenance.
  • The price of the strips and the meter.

In the United States, you can find the test strips over the counter at big box stores, independent retail pharmacy, and many websites, including Amazon, eBay, and GoodRx. You can find them in the gray market.

Test strips are covered.

According to survey data passed directly to us from the diabetes research firm dQ&A, most people with diabetes get their test strips through health insurance — 82% of people with type 1 diabetes and 76% of those with type 2 diabetes, to be exact.

Test strips can be very expensive even with this coverage.

For one thing, if you have a high deductible health plan, you still might need to pay over-the-counter prices for supplies (and, sadly, insulin) until you meet the deductible.

However, you could catch a break if you have a health savings account (HSA), as the Treasury Department recently said that diabetes supplies — and insulin — would be covered in high deductible plans for people who have HSAs.

Also, your insurance might not cover the brand of test strips you want. Many insurance plans put specific “preferred” brands of meters and test strips in their top formulary tiers. That means brands not in those tiered lists will cost much more.

“This can be a problem for people who need specific meters that transmit readings to their diabetes pumps, or for people who switch insurance plans and don’t like the meters and strips covered by their new plans.”

Stay optimistic if you’re in that situation. Your doctor might be able to help you get coverage for diabetes supplies by writing a “letter of medical necessity” to the insurance company. It all depends on the reasons for the denial and the guidelines of your insurance policy. Check out how to appeal insurance decisions here.

Does Medicare. cover diabetes test strips?

Yes! Blood glucose meters and the necessary test strips are covered as durable medical equipment by Medicare. Part B, which applies to medical services and supplies necessary to treat your health condition.

What is durable medical equipment and why does it matter?

Durable medical equipment is a classification by the Centers for Medicare. & Medicaid Services for primary types of medical equipment for home use. In diabetes, items that do not have this classification are typically much more difficult to get covered by insurance.

All of the test strips work the same way. You can place your blood sample on the end of the strip and get a reading with a small sensor embedded in it. The amount of blood required, time to result, and cost are some of the differences found in strip brands.

If you buy them without insurance, the costs can be very high.

The brands shown by Amazon at these comparative costs are an idea of the range.

Prodigy

  • All of the Prodigy meter models are compatible.
  • The blood must be 0.7 microliters for testing.
  • Results in 7 seconds.
  • For alternate site testing, it was approved.

Cost: about $0.15 per strip

ReliOn

  • Arkray made this compatible with all ReliOn meter models.
  • The blood sample size is required.
  • Results in 7 seconds.
  • allows testing of hands.

Cost: about $0.29 per strip

CVS Health Advanced

  • compatible with the Advanced ProHealth Glucose Meter
  • The blood sample size is required.
  • Results in 5 seconds.
  • easy to handle design

Cost: about $0.22 per strip

Bayer Contour Next

  • compatible with all of the models of the Next Glucose meter
  • A blood sample of 0.6 microliters is required.
  • Results in 5 seconds.
  • Second-chance sampling allows you to apply more blood to the test strip if you need it, which may help prevent wasting test strips and save money.

Cost: about $0.38 per strip

Accu-Chek Guide

  • All three Accu-Chek Guide meter models are compatible with the other two.
  • A blood sample of 0.6 microliters is required.
  • Results are under 4 seconds.
  • The SmartPack is a unique spill-resistant vial that you can use to take one test strip at a time.

Cost: about $0.45 per strip

OneTouch Ultra

  • Only the OneTouch Ultra2 and OneTouch UltraMini meters are compatible.
  • A blood sample of less than 0.4 micro liters is required.
  • Results in 5 seconds.
  • patented DoubleSure Technology checks each blood sample twice for accuracy

Cost: about $1 per strip

The manufacturer says that the shelf life of most test strips is 18 to 24 months.

Diabetes author and educator Wil Dubois explains, “most strips… can be used for a good period beyond their official expiration date. But at the same time, with all the variables that can impact a strip’s lifespan and the tremendous variety of strips out there, I don’t think we have a prayer of getting a hard-and-fast rule about how long a typical strip might last.”

He says that the longer you use expired test strips, the more likely you are to get incorrect results.

What do you do with expired diabetic test strips?

If you want to be a good citizen of the planet, it’s best not to throw out medical waste in regular trash bags or public trash bins, including glucose test strips, lancets, or alcohol swabs.

Once the strips expire, it’s best to put them in dedicated bio waste containers along with other medical waste, as noted by the Diabetes Council. Read a guide to recycling and disposing of the various components of your glucose testing kit here.

Do you need a prescription to buy diabetes test strips?

“You don’t need a prescription to buy test strips over the counter. Insurers usually require a healthcare professional to have a prescription for certain supplies.”

Which glucose meter has the cheapest test strips?

Prodigy test strips for several brands of Prodigy meters appeared to be the cheapest at the time of our research in August 2022.

Even among the most budget-conscious glucose meters and strips, many factors may affect your product choice. See this guide to drugstore brand glucose meters for details.

Is it legal to resell diabetes test strips?

There’s no law against buying and selling diabetes test strips on the open market. As a result, a growing “gray market” has emerged, where companies buy and resell test strips. Go online and you’ll find more than a few outfits doing this, with names like TestStripSearch.com, QuickCash4TestStrips.com, and Stripsupply.com.

As mentioned in another article, the savings here don’t appear to be that great, and given that the quality control in these outfits is uncertain, we urge caution. Some sellers may try to peddle expired goods, for example.

Partly in response to this gray market, California has begun to regulate the supply chain of diabetes products, including glucose test strips, to prevent fraud and ensure patient safety.

The FDA issued a warning to consumers about the safety of “pre-owned or unauthorized” test strips in April 2019. However, the agency noted that it was unaware of any deaths or serious injuries from these strips.

In other words, beware.