Insulin pumps

The day Katherine Coupland turned 19 was also the same day she was “aged out” of her province’s insulin pump program, which covered the cost of purchasing the medical device for eligible residents aged 18 years or younger.

As her pump’s five-year warranty approached its expiry date, Ms. Coupland began to worry. Would she able to afford a new pump – which would likely cost between $6,000 to $7,000 – when her old one stops working or will she have to start injecting insulin again to manage her type 1 diabetes? 

“Using a pump has allowed me to drastically reduce my average blood glucose (sugar) level, which in turn lowers my risk of developing other diabetes-related complications in the future,” says Ms. Coupland, who is now 21 and a fourth-year biology student at the University of Victoria in British Columbia. “It would be challenging, life-changing and devastating for me to not have my insulin pump.”

Ms. Coupland’s worries were eased when the B.C. government raised the maximum qualifying age for insulin pump coverage from 18 years old to 25 years old. But she knows that in four years, she’ll have to start thinking again about what she’ll do when it comes time to replace her pump.

She’s not the only one facing this challenge. A study by the Canadian Diabetes Association (CDA) found that the cost of medications, devices and supplies presents a significant challenge to people with diabetes. Those with type 1 diabetes who use an insulin pump generally face “far higher” out-of-pockets costs than those who don’t use a pump, according to the report.

Because of the considerable expenses associated with managing diabetes, close to 60 per cent of Canadians with the disease don’t comply with their prescribed therapy, says the report.

Jake Reid, director, government relations and advocacy - Atlantic at the CDA, says provincial coverage of medical devices, medications and supplies is a vital necessity for many Canadians with diabetes. But different coverage levels across the country makes managing their diabetes easier for some and incredibly difficult for others.

“Some provinces – for example, Ontario and Alberta – don’t have age restrictions on insulin pump coverage, whereas coverage for pump programs in Atlantic Canada ends when you become an adult,” says Mr. Reid. “ When it comes to managing your diabetes, it still matters where you live in Canada. Our vision within the Diabetes Charter for Canada is that all Canadians with diabetes no matter where they live have access to the supports they need to live life to their full potential.”

Given the body of evidence showing that insulin pump therapy provides sustained improvement in glycemic control, it’s important for Canada’s provinces and territories to give their residents low- or no-cost access to these medical devices, says Mr. Reid. The CDA has been working towards this goal with provincial and territorial governments across the country, he says.

“We’re asking that governments open up access to insulin pumps regardless of age,” says Mr. Reid. “We know that if a person can use an insulin pump to take care of themselves, then that can help prevent them from developing complications and reduce health care system costs down the road.”