As Cost of Living Rises, Diabetes Remains a Costly Condition for Atlantic Canadians | The Canadian News

Emily Gouthro says she is lucky to have health insurance. Otherwise, you will have a hard time controlling your diabetes.

“Even if you have coverage in Nova Scotia, sometimes it’s only 80 percent of salary,” Gouthro said in a recent interview. “And that’s if you have great coverage.”

Gouthro, a registered nurse, was diagnosed with type 1 diabetes when she was four years old. The cost of your insulin is fully covered by your insurance plan. But, as she explains, the costs go far beyond the insulin itself.

People with type 1 diabetes often rely on insulin pumps, which can cost thousands of dollars, to administer their medications. Then there is the cost of insulin reservoirs, infusion sets, test strips, and other equipment.

“A lot of people don’t realize that this disease is so important,” Gouthro said. “It’s 24 hours a day; you’re thinking about it all the time.”

Goutro said that under his insurance plan, he receives $ 10,000 to cover insulin pumps for life.

But if you know anything about insulin pumps, they typically range from $ 4,000 to $ 6,000. That’s only for the pump itself, and the warranty is only valid for four years, ”he said.

“They say you only get $ 10,000 for life, but the insulin pump will only have it for a couple of years. And then what are you supposed to do?

As for the rest of your supplies, you have to pay hundreds of dollars out of pocket each month and wait for your insurance to reimburse you.

“You are always going to have something on your credit card or waiting for your money back,” he said.

“Even if you have coverage, and you are lucky to have it, you still run out of money and are still waiting to get it back.”

As a child, her family had to raise funds to buy her first insulin pump. Nova Scotia now has an insulin pump program, but that only covers pumps for people under the age of 25.

“The coverage here is so backward and so poor. It’s great that there is coverage for up to 25, but their illness doesn’t go away after 25, “he said.

“It is almost discriminatory that after 25, you will not receive the aid, you will not be able to cover your pump, you will not get the basic supplies you need.”

Gouthro said that if diabetes is not managed properly, that can lead to many more serious problems down the road, putting more pressure on the health care system, something she has seen in her work as a nurse.

“If you agree, you have the minimum supplies, the minimum treatment, then you get there and you can have kidney failure, you can deal with blindness, you have amputations. It’s all the scary things you hear about, ”he said.

“If our province could help give people the tools to have the best possible chance with their disease, it would be great. It would give everyone a better chance. “

He said he’s hopeful that the Tim Houston administration, which has focused much of its mandate on health care, will make changes so that people with diabetes can afford their supplies.

‘Prohibitive’ costs

Diabetes Canada agrees that some other jurisdictions are doing better. According to their website, BC, Alberta, Ontario, Yukon, the Northwest Territories, and Nunavut cover insulin pumps and supplies for eligible people of all ages.

Nova Scotia, New Brunswick, PEI and Saskatchewan limit insulin pump coverage to 25 years, while Manitoba, Quebec and Newfoundland and Labrador limit it to 17.

However, in Manitoba, full coverage is provided to those recommended by an endocrinologist, and Newfoundland and Labrador say it will cover people up to 24 who are already in the program and meet the criteria. New applicants over the age of 18 who meet the criteria will undergo an income test.

Insulin pump coverage is inconsistent across the country, notes Diabetes Canada.

“Canadians living in provinces with limited coverage or who do not meet the eligibility criteria for their provincial plan must pay out of pocket for insulin pump therapy, which is priced from $ 6,000 to $ 7,000,” the site says. website Diabetes Canada.

“Also, the ongoing expense of monthly supplies is a limitation for the use of insulin pumps, which cost up to $ 300 each month. For many people, these charges are prohibitive. “

Brooks Roche, Diabetes Canada connection and patient awareness manager, has lived with type 1 diabetes for most of his life. He described it as a “relentless” disease that requires constant self-control.

“Every entry, whether it’s food, sleep, exercise, stress, illness, weather, it all comes into play,” he said in an interview from Charlottetown, PEI.

“Basically, we are always looking for some normalcy, and there are no breaks or days off.”

‘Horrible decisions’

Roche said that people with type 1 diabetes who use insulin pumps can expect to pay $ 6,000 per year for their supplies, while those with other types of diabetes pay about $ 2,000 per year on average.

He said the high price of diabetes is an especially serious problem in the four Atlantic provinces, which are the bottom four in the country in terms of median family income.

“These out-of-pocket costs don’t know what province or territory they are in, so they consume a much more significant portion of the income of people in Atlantic Canada,” he said.

“It really adds up when people have to make these horrible decisions that we hear about, where is it: ‘Do I pay for all the groceries that I need, or that my family needs this month? Or do I get this technology or treatment that I need to maintain a good quality of life? ‘

“Those are not choices that we want people to make in a country with supposedly universal health care.”

He said the logic behind putting age limits on insulin pump coverage “is breaking down very quickly,” since people of any age can be diagnosed with diabetes.

While Roche is encouraged by the federal government’s commitment in the latest budget to fund a national diabetes framework, he said more work needs to be done at the provincial level to ensure that people with diabetes have access to the equipment they need.

Noting that Sunday marks World Diabetes Day, and this year marks an important anniversary of the discovery of insulin, Roche said now is the time for the provinces to step up.

“It is very important to take advantage of that momentum and transfer it to the provincial decisions that are being taken,” he said. “This is the right time, because 2021 is the centenary of the discovery of insulin … and we must celebrate it.”

In a statement, Marla MacInnis, a spokeswoman for the Nova Scotia Department of Health, said in an email that eligibility for the provincial insulin pump program is “based on meeting medical criteria and determining financial support based on of income and family size “.

“The age associated with this program was based on an assessment of the needs of Nova Scotians along with a jurisdictional scan at the time the program was implemented,” he wrote. “The Department periodically reviews its programs to ensure they meet the needs of Nova Scotians and welcomes feedback on the Insulin Pump Program.”

Meanwhile, New Brunswick Health Minister Dorothy Shephard told Global News last week that insulin pump coverage is an important discussion, but has been delayed due to COVID-19.

“It’s always been my intention that we have this kind of conversation … but it’s just that the department has had so many fires to deal with that this conversation has been delayed,” he said.

The cost of not controlling diabetes

Dr. Tom Ransom, Nova Scotia endocrinologist for Capital Health, said there have been many advances in the last century when it comes to diabetes management and insulin delivery, and there is now a “menu” of supplies that help people with diabetes to control their disease.

However, the cost of these supplies remains a barrier, especially for the uninsured or uninsured.

“People who are employed and have private drug plans will have these things covered. But unfortunately for the working poor, people who maybe are self-employed or don’t have the best drug plan, or when they got a job had pre-existing diabetes, so it wasn’t covered, for these people, they are in a real bind. ” , said.

“It’s like sacrificing ideal care at a cost and putting yourself at risk.”

Ransom said the question is less about the cost of controlling diabetes and more about the cost of no diabetes management.

“If you are not managing it, you will incur the costs later,” he said. “It increases the risk of eye disease, which can ultimately lead to blindness, or kidney disease, which can lead to dialysis. Or neuropathy (people could potentially lose their feet) and heart disease, heart attacks and the like, which come at a great cost. “

Ransom said he and others have been lobbying the government for “quite some time” to have insulin pumps and other equipment covered, but said things have been delayed due to the COVID-19 pandemic.

However, he is hopeful that the province will begin to cover these important supplies.

“I talk to people who have diabetes all day and advocate for them whenever I get the chance,” he said.

“For me, it makes sense to have these things covered.”