Opinion: Don’t change Alberta’s insulin pump program without meaningful consultation

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About 40,000 Albertans live with type 1 diabetes, a disease in which the pancreas does not produce enough insulin. The cause of type 1 diabetes remains unknown and we don’t know how to prevent it.

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The good news is that we now have two technologies that help reduce the burden. The first is the insulin pump, which allows people to fine-tune the delivery of insulin doses, avoiding the need for multiple daily injections. The second is the Continuous Glucose Monitor (CGM), which lets people know their blood sugar levels in real time instead of relying on painful and embarrassing daily finger taps. Interestingly, there are even artificial pancreas systems where pumps communicate with continuous glucometers to automatically adjust insulin doses, dramatically improving blood sugar control and quality of life. Access to these technologies can give people a sense of normalcy in their daily lives.

The bad news is that managing type 1 diabetes is extremely expensive, even with private insurance. Without access to medications and supplies, people with diabetes are forced to “blind drive,” dosing insulin without knowing their blood sugar levels. In times of financial hardship, they can sometimes unsafely reuse supplies or ration insulin. Incorrect insulin dosing can lead to complications such as seizures, coma, stroke, kidney failure, blindness and amputation.

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These complications increase the physical costs for individuals and the financial costs for the taxpayer.

The Alberta Insulin Pump Therapy Program (AIPTP) provides access to insulin pumps and supplies, removing a significant financial barrier to therapy. In August 2021, the Government of Alberta announced a flawed three-phase approach to access to diabetes technologies.

The first phase involved CGM coverage for children under 18. The challenge is for children with type 1 diabetes to grow into adults with type 1 diabetes who end up with an annual bill of $3,600 if they want to continue using these life-changing devices until death. adulthood. CGM technology is now the gold standard of care according to Diabetes Canada and is covered by government health insurance plans in other provinces such as Ontario and Prince Edward Island.

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The Alberta government wants AIPTP members to pay for additional private insurance that does not adequately cover the costs associated with the pumps. The changes they propose involve additional costs to manage an already distressing and costly disease throughout life.

It is important for Albertans to understand that for people with diabetes to live a semblance of a normal life with type 1 diabetes, the AIPTP program is a necessity, not a luxury.

The government’s proposed changes suggest there has not been meaningful consultation with people living with type 1 diabetes. After a public outcry over the proposed changes, the government held a public meeting. At the town hall, callers raised concerns about the lack of consultation, oddly structured individual and family co-payment models, and the government’s emphasis on immediate cost savings, and ignorance by government evidence showing that pumps and CGMs help people live more fulfilling lives. , while reducing costly health complications.

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The government’s plan also ignored evidence showing that co-payment models reduce quality, access and equity of care, and do not reduce overall health spending. It also appears that the recommendations to AIPTP published in 2021 in the Canadian Journal of Diabetes have not been taken into account. Subsequent decisions about changes to this program should meaningfully involve the type 1 diabetes community and be evidence-based.

The Canada Health Act states that “continued access to quality health care without financial or other barriers will be essential to maintaining and improving the health and well-being of Canadians”. All Albertans should be concerned that a new precedent will be set for people with life-threatening chronic conditions.

Alberta is a world leader in diabetes health care and research, but UCP health policies remain substandard for people with type 1 diabetes. made to health policy do not include consultation of those affected, are we doing more harm than good?

Heather Hinz is a kinesiologist and a person living with type 1 diabetes in Alberta.

Jamie Boisvenue is a chronic disease epidemiologist and PhD student specializing in type 1 diabetes research at the University of Alberta School of Public Health.

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