Minimed and United Healthcare

My perception is that Minimed is actively trying to block existing and new entrants into the pump market since they are first to market with the 670G and are building sole source contracts.

  1. United Healthcare has a sole source contract with Minimed
  2. Tandem’s new Summer 2019 pump release will exceed the capability of the 670G leveraging both basil and bolus automated features. Minimed will not have this combination of features until 2020 at the earliest
  3. Tandem pumps are easier to update than Minimed, with a modern software/hardware architectural design
  4. Tandem’s integration of Dexcom’s sensor appears to be a superior product
  5. Minimed is actively pushing their 670G through group “information sessions” that are just sales meetings to lock folks into their pump before Tandem’s new release

My pump warranty expires in February 2019. With Minimed’s ever decreasing level of customer support and predatory business practices, I am not sure it is in my best interest to go with another Minimed product after 28 years using their machines. I want a dynamic market of innovation and the Minimed gorilla appears to be stifling other manufactures.

The issue I have is the United Healthcare sole source contract. Has anyone else found a way around the contract?

Charles @mday, I agree with much of your reporting and your analysis. I am in a position similar to you except that, my MiniMed pump warranty expired on May 22, 2018. Providing a direct answer to you question [your last sentence], I have two suggestions:

  • Find a health insurer other than UHC. Assuming that you work for a large employer, there could be choices for you. I’ve looked and for most of my needs UHC remains my best choice [Medicare co-ordination] ;

  • Go directly to another pump supplier and have that company negotiate for you either directly or through one of their suppliers - I used this method to have UHC cover my DexCom CGM sensors.

Your message implies that Medtronic may be doing something illegal; if you truly believe this, you should file a complaint with your Attorney General.

Good Luck!!!

Thank you for your note and guidance. Tandem and my HR department have been very helpful. My HR department was surprised the agreement existed.

For those encountering a similar issue:

  • My employer is self insured, so has UHC managing their supplied insurance benefits. This allows them to make changes on your behalf. The reason I mention this is you have no leverage if you are simply “buying” a UHC insurance product in the marketplace.

  • As a self insured company, my insurance coordinator was able to add my name to our “exclusion list,” allowing me to seek the pump system of my and my health care provider’s choice.

  • I had to be insistent again…and again…and again. Tandem was very helpful pushing the issue once I was added tot he exclusion list, forcing the issue with UHC (they still pushed back).

I recognize Tandem (I will put Insulet in the same camp) is new and financially ‘risky.’ However, they act like Minimed used to act. They were helpful, they were my advocate, and they provide competition in the market to restrain the Medtronics in the world. If we do not act to push for coverage, and take a risk on these companies the Medtronics of the world will not change to support US the Customer/Patients.

Charles @mday, I’m happy to hear that you are making progress.
Having worked in corporate risk management I’m fully aware of the “self insured” concept with someone like UHC or Cigna as the front side manager. Right now I’m looking forward to Medicare and Tandem to do the same for me with UHC.
As a side note, I will add that the United Health Medicare Advantage plan has been really good , and cost effective, for all my medical care - and I’ve got ,many health concerns.

I’m in the same boat!

My Tandem is about to go out of warranty and my company does not offer a “pharmacy Benefits” option that would allow me get a Tandem pump through a pharmacy instead of UHC. I was told I need to have my doc write a letter saying that a Tandem/Dexcom combo is medically necessary, and then I MIGHT be able to get out of the Medtronic exclusivity. My doctor, my Tandem rep, and my company’s HR all aren’t optimistic that I’ll be able to convince UHC.

Has anyone succeeded in having UHC waive the Medtronic exclusivity?

I would not say the blame is entirely with Minimed. I used to have UHC through work, and it would get deals with different insulin manufacturers each year, and different suppliers. It was sold as a way to save money. But it is really them lining their pockets with kickbacks from the manufacturers. And by allowing only a single pump manufacturer, that manufacturer has a huge amount of guaranteed business taken away from other manufacturers, and so they have enough profit to reduce premiums. It also means they take away free choice. Everyone in this country is so hung up on freedom of choice, that it costs money. A national health system would be cheaper, and in this country, that system would severely limit our choice and our service, in an attempt to save money. I went on Medicare two years ago, and I have all sorts of problems getting supplies before going on vacation. And I have problems even getting drugs filled in advance of a trip abroad. I just hope “Medicare for all” never becomes a reality. I spend hours on the phone trying to get each order taken care of. And this costs the suppliers lots of money, which raises the costs of our healthcare. And you, taxpayers are paying for this. You talk about decreased customer service: this is the company’s way of saving money and making more profit. After being told Medicare submitted some diabetes supplies for competitive bidding, the winning bids were loss leaders, and the other competitors left Medicare. The one I use has such a poor workforce that 1) They can hardly understand English 2) They have to be phoned 5 times for each order. And my Part D drug company uses employees who read scripts. It takes 20 minutes to place an order, and then the order does not come, so I end up calling back 5+ times about it. All this bad service is a really unfortunate result of our country putting profits above people and service.

I used Minimed (Medtronic) many years ago before switching to Tandem and have never looked back. Minimed was great when I had it but sure seems to have gone downhill, from what I’ve been reading. My suspicious little mind is imagining Minimed getting UHC to lock out other pumps so they can guarantee themselves some share of the market rather than improving their product. Barring a successful and difficult to achieve override, that leaves patients stuck until open enrollment when they can hopefully change plans. I’m not saying that’s the case, just indulging in possibilities. Maddening!
Is going back on injections an option? Many people find pumping gives better control, but if your pump experience is that bad…