Concerns over lack of details, increased costs around changes to Alberta’s Type 1 diabetes insulin pump coverage

Albertans with Type 1 diabetes are raising concerns, after the provincial government announced changes to its insulin pump benefits program that may leave patients paying more out of pocket.

Insulin pump therapy is a diabetes management method that uses a pump — a small, battery powered device about the size of a pager — to give small continuous amounts of insulin to patients instead of multiple daily injections.

“Being on an insulin pump changes my life,” said Lesley Thompson, a woman with Type 1 diabetes. “It’s a day and night change. Without a pump, you’re on multiple (insulin) injections a day. You’re testing your blood sugars, you’re figuring out all the things you need to do; every time you eat you have to figure out the math of how much insulin you would take.”

Previously, patients in Alberta could get their insulin pumps — which in Canada, can cost between $6,000 and $8,000 without coverage — paid for with the province’s Insulin Pump Therapy Program.

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However, this week the government said that program would be discontinued and those using it would be transferred to “government-sponsored health benefit plans” on Aug. 1. That change means that those without health plans from an employer will be required to sign up for government health coverage plans.

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The government says it will allow patients to access newer, more advanced models of pumps.

But Thompson, who has had Type 1 diabetes since she was 16 years old, says the announcement didn’t provide enough information — and that many employer benefit plans do not cover the pumps.

“(The release says) if you have employer-backed insurance it will cover it,” Thompson said. “But the thing is, a lot of employer-backed insurance doesn’t cover this, because (the Insulin Pump Therapy Program) covered it.

“And even before this program existed, (some) employer-backed insurance didn’t cover it. They considered it cosmetic. You can get by with multiple (insulin) shots a day, and good for you.”

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According to the Alberta government, about 4,000 people in the province currently receive their insulin pumps, equipment and supplies through the Insulin Pump Therapy Program.

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The changes are the final phase of a three-phase plan from the government that it says are meant to enhance care for people with diabetes. In Phase 1 announced in August 2021, coverage was provided for diabetes test strips and supplies. Phase 2 gave funding for continuous glucose monitors for patients under 18. 

The CEO of Diabetes Canada endorsed the changes to the pump coverage program, saying the organization looks forward to improving treatments for Albertans with the condition.

“Diabetes Canada looks forward to working with the government for continued improvements to access diabetes supplies, medications and devices that will help improve the quality of life for all Albertans living with diabetes,” Laura Syron said in the news release.

Read more: University of Alberta study shows positive signs to get patients with diabetes off injected insulin

But for Thompson, she worries about having to make a switch away from the pump if the new coverage isn’t adequate.

“Without this program, it’s financially concerning. Because insulin pump therapy is expensive.”

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“Not having 100 per cent coverage through this program means I (may) have to go back to multi-daily injections,” she said. “I will be on four plus shots a day, I will be on a long-acting and short-acting insulin. I will have less flexibility in my life.

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“It would be great to give people details, because right now a community of us — of 4,000 of us — that are on this program are really stressed because we don’t know what the future holds.”

Alberta Blue Cross has told patients that letters were sent out May 2 to those enrolled in the Insulin Pump Therapy program with more information.

Global News has reached out to the government of Alberta for a response to patient concerns. This story will be updated if comment is received.

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