Thursday, May 30, 2013

Alberta government provides coverage for insulin pumps

Albertans with Type 1 diabetes who meet clinical criteria can receive coverage for insulin pumps and basic diabetic supplies through the government’s new Insulin Pump Therapy (IPT) program.

“We made a commitment to provide insulin pump therapy to all who need it and who aren’t fully covered for it, and we are following through on that commitment,” said Fred Horne, Minister of Health. “It’s important that Albertans with Type 1 diabetes have access to pumps and supplies as a tool to help them manage their condition. For some people, insulin pumps and supplies can prevent complications that affect their health, and greatly improve their quality of life.”
IPT is a way of managing diabetes by administering insulin using a pump, a device that is an alternative to multiple daily injections. About the size of a pager, the portable, programmable pumps deliver fast-acting insulin through a small tube that is inserted beneath the skin.

Government will cover the full cost of insulin pumps and supplies for eligible Albertans with Type 1 diabetes, less any amounts covered through government-sponsored agencies and patients’ employer-sponsored or private insurance programs. Participation is based on eligibility criteria and clinical criteria established by health professionals who understand diabetes and safe treatments for patients.

The IPT program will also cover pump supplies for up to five years for people already using a pump. Pumps typically last about five years, so existing users will need to be assessed and meet eligibility and clinical criteria if they wish to receive a new pump and ongoing coverage for supplies through the program by the time their current pump is five years old.

“Pumps are expensive and while covered under some circumstances by employee benefit plans, IPT hasn’t been an option for some people who might benefit from a pump,” said Dr. Alun Edwards, Senior Medical Director for Alberta Health Services’ Obesity, Diabetes and Nutrition Strategic Clinical Network and an endocrinologist in Calgary.

“It is important to realize that IPT is a serious commitment which takes a great deal of work and attention from the user and success with pump therapy only comes with effort. Pumps don't necessarily benefit everyone but might helpful for those who suffer frequent hypoglycemia (low blood sugar), planning or proceeding through a pregnancy, or have scheduling demands, like shift work," he added.

New pump users will need to be referred to the IPT Program by their physician or nurse practitioner, and have an assessment completed at one of the 11 diabetes insulin pump clinic locations across the province approved by Alberta Health Services to deliver the IPT Program. The assessment and training process can take up to several months to complete. Existing pump users will need to follow the same referral process to obtain an assessment before their current pump is five years old.

“We applaud the Government of Alberta for recognizing the importance of insulin pump coverage,” said Emily Johnson, Alberta Advocacy Committee Chair and National Advocacy Council member, Canadian Diabetes Association. “As noted in the Association’s 2011 report, an insulin pump program will not only improve health outcomes for Albertans living with type 1 diabetes, but will also improve the sustainability of the province’s healthcare system by preventing and delaying serious and costly complications from diabetes. The association looks forward to working closely with the government to ensure that the program meets the needs of eligible Albertans living with type 1 diabetes who would benefit from an insulin pump.”

"Obtaining insulin pump coverage through an Alberta government-funded program has been a long-standing priority for JDRF  because we know the positive impact it can make in the lives of those suffering from Type 1 diabetes,” said Jim Casey, volunteer Board member with the Edmonton Chapter of the Juvenile Diabetes Research Foundation. “There are thousands of people in Alberta who cannot, due to financial reasons, use insulin pump therapy even though it was recommended by their physician.  For those Type 1 diabetics whose doctors indicate they can benefit from insulin pump therapy, this program gives them a better tool to manage this chronic disease and enhance their quality of life."

Budget 2013 committed $5 million for the first year of the new program.

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