People in B.C. will have coverage of insulin pumps for Type 1 diabetes, regardless of age, following up on the initial announcement, starting Tuesday, July 3, 2018.
With this change, a financial weight has been lifted from the shoulders of students and young adults who would otherwise have to lose their insulin pump, something that may have been a part of their lives since they were children. Up to now, many people over 25 years old, who rely on an insulin pump to manage their chronic disease, have been forced to make the choice between purchasing this device for their health, or foregoing it, due to cost.
Ramya Hosak is a community leader and passionate young professional who lives with Type 1 diabetes. This announcement brings her life’s work on uniting the Type 1 diabetes community into focus.
“People don’t realize how important choice is for treating Type 1 diabetes. Pump or insulin injections—we need to have the ability to choose. The pumps mean so many things to the Type 1 diabetes community. People were afraid of losing theirs, due to cost, as it’s been a part of their lives forever. Or people felt like the option to try a pump was removed for them, if they were diagnosed as adults and relied mostly on insulin injections. Diabetes doesn’t end at age 25, so why should pump coverage? Now we have this choice and are so, so happy for it,” said Hosak, who has 11 years of personal experience with diabetes.
Diagnosed at age 19, in second-year university, the diagnosis catapulted her into a world that was suddenly ruled by two things: the clock, and her blood sugar. Checking levels every two hours, trying to determine what to eat and what not to eat, when it was OK to work out at the gym and the added traditional stress of university exams all led Hosak to a conclusion: Type 1 diabetes was majorly affecting her life and it was isolating.
“I went from being a normal university student who enjoyed an active social life, going out with my friends without a second thought. Now, I suddenly had to be so careful. I felt a need to act like everything was fine and hide the toll an invisible ‘full-time job’ of Type 1 diabetes was having on me, mentally and emotionally. I stopped reaching out to my friends for fear of being seen as a complainer and not having a positive attitude. It gets lonely,” she said. “I hear this a lot – young people at this transition stage often feel uncomfortable speaking with their doctor or parents about complex issues that arise for an adult with Type 1 diabetes - unsure as to whether they can ask their health-care professional about having a few alcoholic drinks, for example.”
Hosak was determined to connect, to hear the stories of others and share her own. After completing a bachelor of science, with a focus on public health, she volunteered with the JDRF (Type 1 diabetes research and advocacy group), eventually leading their youth ambassadors program for children with diabetes (aged 10-12 years), and meeting fellow volunteer and, later, her husband, Mark Hosak, who was diagnosed at age 10 with Type 1 diabetes.
“When working with the youth ambassadors, it was so amazing to hear these kids meet with other kids who shared the same diagnosis. They told stories of bullying at school when their pumps were seen as strange, compared pump colors with each other, and it was just so normal.”
Seeing how important connection was for the kids, Ramya Hosak sought out to create that for herself, and other young adults diagnosed with Type 1 diabetes.
Slowly meeting other young adults with Type 1 diabetes spurred Kosak on to co-found the community Young and T1—a social group and online presence to allow others like Ramya and her husband, Mark, to open up, be themselves, find information and share resources.
“People need a village. They need to be connected in person and online to reach as many people as possible. I’m most proud of the Young and T1 community online, who at 450-strong across the Lower Mainland, have helped members in real-time with some pretty intimate and personal questions, and with help with mental-health concerns when people are struggling to manage their chronic illness,” Hosak said.
The community is not for providing medical advice. It provides real, lived experiences, hard-won from the folks who have been in the same shoes. She shared an example of a young person, recently diagnosed, who had eaten dinner and not remembered if he’d taken insulin or not. He needed help quickly. The community was able to respond within minutes online, reassuring him with similar experiences.
The Type 1 diabetes community has many unique faces and stories. Hosak is quick to emphasize that her voice is one of many. Everyone has a personal story to share about their journey with Type 1 diabetes. She’s proud of the announcement, both for the impacts it will have on people living with Type 1 diabetes day to day, but most importantly, how the future will be improved by better blood sugar control through insulin-pump access, reducing the risk of serious complications for those living with Type 1 diabetes.
“Twenty years from now, our health-care system will benefit from this announcement. Isn’t it a great feeling to know that from one decision, you’re making a choice for a better future?” Hosak said.
Patients must meet with their diabetes physician specialist to determine whether they meet the eligibility criteria for an insulin pump.
The patient’s physician would then apply to PharmaCare’s special authority department for insulin pump coverage. People who are eligible for coverage are individuals who are covered under Fair PharmaCare, Plan C for B.C. income assistance, Plan F for Children in the At Home Program or Plan W for First Nations Health Benefits. They must have Type 1 diabetes or another form of diabetes requiring insulin, have confirmation from their endocrinologist that they meet the medical criteria for an insulin pump and have received special authority coverage approval.
“We have heard from many individuals diagnosed with diabetes about how insulin pumps allow them to better manage their condition and improve their quality of life, and how age-restricted coverage forced them to make the choice between purchasing it, or foregoing it due to cost,” said Adrian Dix, Minister of Health.
“British Columbia is setting the stage as leaders in providing the type of care British Columbians with diabetes need. We are proud to follow through on Premier John Horgan’s promise to remove age restrictions on insulin-pump coverage, so everyone who is benefiting from this device is able to continue to live their lives to the fullest.”
- British Columbia became one of only three provinces to cover insulin pumps for people living with diabetes requiring one, regardless of age.
- Approximately 485,000 British Columbians live with diabetes. It is expected that roughly 830 adults over 25 years of age will benefit from the expansion in the first year.
- PharmaCare covers effective therapies for the treatment and management of diabetes, including a number of oral medications and a range of insulin products.
- In addition, PharmaCare covers insulin vials, cartridges, insulin pens and other diabetic supplies, including needles, syringes and blood-glucose test strips. Insulin pumps can range in cost from approximately $6,000 to $7,000, and require replacing roughly every five years.
- The anticipated cost of expanding insulin pump coverage to all eligible British Columbians, no matter their age, will be approximately $15 million over three years.
To access Fair PharmaCare coverage, people can register here: gov.bc.ca/FairPharmaCare
Learn more about B.C. PharmaCare at: www.health.gov.bc.ca/pharmacare
Read about lifting age restrictions for insulin pumps: https://news.gov.bc.ca/releases/2018HLTH0060-001168
For a picture of Ramya Hosak, visit: https://flic.kr/p/K8x3uZ