The direct cost of a CGM sensor is visible. The cost of an inaccurate or inconsistent one is not but still just as real, and it accumulates in ways that are worth examining carefully, both for individual patients and for the healthcare system that carries the long-term burden of poorly controlled diabetes.
The False Economy of Cheaper Monitoring
There is a tempting logic to reducing the cost of diabetes monitoring by accepting lower performance standards. If a device costs less and still produces a glucose reading, the argument goes, it is better than nothing and certainly more affordable than a premium option. This logic is incomplete, and in some circumstances it is dangerous.
A CGM that reads inaccurately does not simply fail to help. It actively misdirects. A patient who sees a falsely elevated reading and withholds insulin may run dangerously high. A patient who sees a falsely low reading and treats a hypoglycaemia that is not happening risks hyperglycaemia. The decision-making harm caused by inaccurate data is not neutral. It creates clinical risk that translates, over time, into emergency presentations, hospitalisation, and the downstream costs of uncontrolled diabetes.
Alarm Fatigue and Its Consequences
Inconsistent CGM performance manifests in a particularly insidious way through alert behaviour. When a sensor’s accuracy is variable, its alert thresholds become unreliable. Patients begin to experience false alarms like Low alerts that do not correspond to actual hypoglycaemia, or High alerts that prove unfounded when checked with a glucometer.
The clinical literature on alarm fatigue is unambiguous: patients who experience repeated false alerts learn to ignore them. This is not a failure of patient compliance. It is a rational adaptive response to an unreliable signal. But the consequence of an alert that is ignored because the patient has been conditioned not to trust it is exactly the scenario that CGM alerts are designed to prevent.
A single missed genuine Urgent Low alert during sleep carries consequences that no cost-saving on sensor pricing can offset.
The Downstream Cost of Poor Glycaemic Control
The broader economic argument for high-quality CGM access is well-established in health economics literature. Poorly controlled diabetes is one of the most expensive chronic conditions in any healthcare system seen in driving costs through repeated hospitalisation, emergency department presentations, surgical interventions for complications including amputations, and the long-term management of renal, cardiovascular, and neuropathic sequelae.
Patients who achieve sustained Time in Range improvement through accurate, reliable CGM reduce their risk of developing these complications. The cost of a CGM sensor (even at premium prices) represents a fraction of the lifetime healthcare expenditure associated with a single diabetes-related hospitalisation. For medical aids and funders evaluating CGM reimbursement decisions, this is the cost-benefit frame that matters.
The Cost of Discontinuation
There is a hidden cost that is rarely accounted for in technology evaluations: the cost of a patient stopping. If a patient begins CGM with a device that performs inconsistently, generates unreliable alerts, or simply fails to match the confidence of their previous finger-prick routine, they stop using it. Discontinuation is the single biggest predictor of poor outcomes in CGM, because a sensor that is not worn produces no data and no benefit.
Dexcom consistently ranks first globally in CGM adherence meaning that patients who start with Dexcom are more likely to continue. This adherence advantage is itself a clinical outcome. It is also an economic one: a device that patients continue to use and reorder month after month generates more cumulative benefit than a cheaper device that sits unused in a drawer after three months.
What Consistent Performance Actually Protects
When we talk about the hidden cost of inconsistent CGM performance, we are ultimately talking about three things: patient safety, clinical confidence, and system sustainability. A sensor that performs consistently protects patients from decisions based on bad data. It protects clinicians from the uncertainty of not knowing whether to trust a reading. And it protects the healthcare system from the long-term burden of complications that better management could have prevented.
Dexcom One+ was designed with this in mind. Its price point reflects a deliberate decision to extend access to clinical-grade performance, not to offer a lower standard of performance at a lower price. Same sensor accuracy. Same non-adjunctive status. Same Clarity depth. The cost of doing otherwise is simply too high.
