No one denies the new t:slim insulin pump by Tandem looks really cool. It does.

But if you're just getting your feet wet with insulin pumping, or prone to experiencing buyer's remorse, then this Apple'esque pump may not be the best choice for you.

Once you get past the headlines touting the flashiness of this new 21st century-friendly pump (everyone being smitten with thi s device because it looks like a small iPhone with color touchscreen for insulin dosing), you get to the practical question: What if I really don't like it after buying and using it in real life?

Before drowning in t:slim hype leading up to the ADA, I heard back in early May at a JDRF conference in Michigan that Tandem wasn't treating that question the same as most others in the industry do, with a refund policy.

Nope. If you purchase the t:slim but aren't entirely happy with it, too bad. You can't return it. Tandem has taken a hard line stance on this, as in: "if you buy it, you own it." They say the company's not going to be in the business of essentially "unprescribing" a product that a physician has already recommended.

Seriously? Am I the only person who researches all the various device options and then tells my doctor which I prefer?? Are doctors really saying to people out there, "No, I think this pump would be more beneficial to you than this one, as far as BG control." Doubtful.

That's not how this works, Tandem. Sorry.

Oh, and if it were, then other companies selling insulin pumps wouldn't have return policies like they do. Actually, they ALL allow returns. We know, because we asked. The big players selling pumps or CGMs responded to inquiries about their return policies:

  • Animas/One Touch: Has a policy allowing patients to return the pump within 30 days after they are trained, no questions asked.
  • Dexcom: Has a 30-day money-back policy.
  • Medtronic: "We have a 30-day return policy for our products and will refund the insurer and the patient."
  • Omnipod: Has an online-posted policy allowing a 45-day return, under certain conditions.
  • Roche/Accu Chek: Has a 30-day money back guarantee on the Accu-Chek Spirit pump.
  • Heck, even former Deltec folk say they had this with the now-discontinued Cozmo pump.
  • Same with the Abbott Navigator CGM, as those who've used the device say it also had a 30-day return.

It should be obvious as to why this is a smart customer-friendly option to embrace. You know, just in case the actual use of the new device doesn't meet the expectation of the polished marketing messages.

Clarification: we're not talking about "return and exchange" if the pump breaks or malfunctions. That's something entirely different — a point that Tandem recognizes, offering pretty much the same assurances as all other D-device makers do: promising to get you a replacement pump within 24 hours.

Now, I'm not going to lie. The t:slim is pretty awesome looking and I'm a fan. Features that stand out to me are the Insulin on Board calculation, and the user-friendliness. At first, I wasn't impressed with the hype and resisted the temptation to get all overly-excited. That changed once I held the credit-card sized device in my hand and played around with a prototype, though.

But I live by the practice of not purchasing something without first having the chance to do an adequate trial-run (apparently Tandem isn't doing test runs either, a practice that actually does vary between the industry players listed above). A return policy standard reassures me that if a particular product doesn't work out, I have options.

The reality is people invest in pumps and CGMs for all the right reasons, but it sometimes just doesn't work out. Unexpected alerts and alarms make the experience more frustrating than beneficial. (Just ask Wil!) New pumpers might not actually like the experience of being attached to a medical device all the time. Or they might have allergic reactions to the infusion sets or supplies. And some might just not like the product as much as they thought they would. Just like with any other product on Earth, only these are even more important because we wear them attached to our bodies 24/7! It's gotta be the right thing! And how could you know that for sure unless you had a chance to try it out?

At the ADA Scientific Sessions recently, we heard some interesting stats about how many people actually return their pumps or CGMs in the first months after using them (probably for one of the many reasons listed above):

For every one CGMer, two people have the devices but don't use them. And 1 in 3 PWDs who try a pump or CGM scrap it within a few months.

That number is highest for the age 6 or younger market, where only 33% of CWDs have pumps compared to higher percentages as people age. For CGMs, the largest number of people using the devices are 26 or older, with single-digit use among kids, teens and young adults.

What the stats clearly show is that not everyone who buys a pump or CGM ends up wanting to keep it up. Regardless of how "cool" it may have seemed pre-purchase.

Countless fellow PWDs I know have run into these hurdles and challenges, and have opted to return their devices initially and either go back to injections or switch to another brand. I even thought about that, once... after being persuaded that a different pump had all kinds of cool new features that would help me improve my health. But I discovered after actually wearing and using it that I wasn't a fan. Although I didn't get around to returning my pump within the first month's return period, I still appreciated having the option and eventually did switch back to my original pump company.

Heck, even a quick Google search on "return policy" for the respective device-manufacturers brings up dozens of forum and online discussions about this, with people expressing their appreciation that these return policies are available just in case.

So, we asked Tandem: Why wouldn't you offer some sort of return policy?

Tandem spokesman Steve Sabicer says there's no refund policy once a pump is purchased, and that's an industry standard (um, hello?! remember, the list above?!)

He said Tandem "does not have a published returned policy," and if a physician happened to "unprescribe" a pump (something he'd never heard of), Tandem would deal with that on a case-by-case basis.

Also, Sabicer said the company is encouraging something called a "30-day seasoning," to help be sure people are ready for the pump. Hmmm. That sounds like a trial-run to me. Maybe they're just not formalizing it as a trial run. Whatever.

I called the Tandem customer service hotline to test what those in the trenches might hear (and called the other companies support lines, too, just to fish for inconsistencies with their claims, but didn't find any).

For Tandem, a friendly rep told me that if I bought a t:slim and wasn't happy for whatever reason, then a priority would be connecting me with a local area sales rep or territory manager to explore options. This person didn't know if there was a return option.

With the new pump just becoming available, Tandem is still setting up the regional sales force and getting all their ducks in a row. So exploring my reasons for not liking the pump would probably be in order before making any decisions, I was told.

From a business end, this policy makes sense. They are new and don't want to encourage product returns — especially after the whole song-and-dance of getting insurance company approval for these devices and having the payments applied to accounts.

But from a patient and customer-service point of view, it's not very realistic about what happens post-purchase if people aren't pleased with the product.

They started taking customer orders for the t:slim on June 11 while the ADA Scientific Sessions were still ongoing, and word is that shipments will begin in August.

I personally would like to try it out before going through the process of purchasing a t:slim, but if that's not an option than I guess I won't be a new Tandem customer at this point. No loss to me, as I'm happy with the pump I have anyhow.

For others who might be considering the t:slim, I'd say be sure you feel strongly about switching before moving forward, and buyers beware: make sure it's more than just an infatuation with the new Apple-like touchscreen before you commit.

{UPDATE 1/1/13: Tandem has now changed their policy to offer a 30-day return policy. You can review the details on their website here.}