Abbott and Dexcom, the leaders in the continuous glucose monitoring (CGM) market, are preparing for a critical phase in their commercial strategies as a long-awaited decision from the Centers for Medicare & Medicaid Services (CMS) in the United States approaches. This decision is expected to expand the scope of insurance coverage for these devices to include type 2 diabetes patients who do not rely on insulin, a shift that could reshape the competitive landscape in the market.
The Impact of Insurance Coverage on Growth
Abbott announced a slowdown in the growth of its diabetes business during the third quarter of 2026, with CEO Robert Ford attributing this decline to the absence of new reimbursement expansions and pricing pressures in international markets. Ford noted that reaching the type 2 diabetes patient segment remains a challenge in the absence of expanded insurance coverage, while expressing optimism about strong reimbursement growth as soon as the CMS decision is issued.
In contrast, Dexcom showed more stable performance, with Chief Financial Officer Jeremy Sylvain confirming that the company has not experienced pricing deterioration and that its reimbursement system remains stable. Dexcom relies in its pursuit of coverage on a recent study published in the New England Journal of Medicine, which proved the effectiveness of its sensors for non-insulin-using type 2 diabetes patients.
Changes in Formulary Lists
The market is witnessing a shift in coverage lists for pharmacy benefit managers (PBMs), as some accounts of CVS Caremark and Aetna Commercial in 2027 will transition from exclusive reliance on Dexcom products to exclusive reliance on Abbott products. Although Dexcom downplayed the significance of this change, noting that it represents less than 4% of its revenue, this shift reflects the intensity of competition for major insurance contracts.
What Does This Mean for Users?
For patients, this potential Medicare coverage expansion means broader and easier access to glucose monitoring technologies that have proven effective in improving quality of life. However, competition among companies for exclusive coverage lists may limit patients' choices in selecting the device they prefer or that best matches their other devices, such as insulin pumps, putting pressure on care providers to ensure greater flexibility in accessing necessary medical technologies.