'My wallet or my health': Saskatchewan patients call for insulin pump funding
by Zak Vescera"This sounds weird, but I really don't have a Plan B if it fails. I don't know what I'd do."
In Paul Kuspira’s pocket is a device smaller than a cellphone. It keeps him alive.
Kuspira, who has Type 1 diabetes, relies on an insulin pump to dispense a steady stream of insulin to keep his blood sugar stable. In theory, a pump lasts five years. Kuspira’s expired in 2017. A new one would cost him $7,800, more than he can afford.
“It’s just out reach for me … Am I sacrificing my wallet, or am I sacrificing my health?” Kuspira said.
He was one of several people with Type 1 diabetes who appeared in the Saskatchewan legislature on Monday and Tuesday to urge the province to make pump coverage universal. Current policy only covers pumps for people aged 25 or younger.
Most people with the condition inject insulin manually, but many claim pumps are essential for their health.
Patrick Tohill, director of government relations with the JDRF charity, said the pump — which delivers a “background” stream of insulin, plus manual doses — helps avoid crashes associated with the condition. His organization is lobbying for every province to cover the pump.
“A colleague of mine used to talk about it like being a pilot,” Tohill said. “You don’t want to be too low and crash, and you don’t want to be too high, either. Staying inside that range isn’t easy.”
Joan King, Diabetes Canada’s director of government relations for the western provinces, estimates only 30 per cent of eligible people would choose the pump over injections.
“It’s not an answer for everybody … but some people are really desperate for it,” King said.
Her organization estimates 5,000 and 10,000 people with Type 1 diabetes lived in Saskatchewan as of 2018. King said she can’t speculate about how many would want a pump if the government were to cover the cost.
Health Minister Jim Reiter noted Monday that the province raised the coverage age from 18 five years ago, putting it in the “middle of the pack” among Canadian provinces. He said he’ll explore expanding coverage, but it would be balanced against other health care priorities.
“If it was just simply a matter of good programs versus bad programs it’d be easy, but frequently it’s good programs and other good programs competing for the same health care dollar,” Reiter said.
Dr. Munier Nour, a pediatric endocrinologist, cautions that insulin pumps aren’t a silver bullet; users still need to manually check their blood sugar, for example. He’d like the government to explore funding continuous glucose monitoring devices, which could simplify that process and compliment insulin pumps.
“I think there’s a misperception that insulin pumps will take over diabetes care,” Nour said. “That’s not true, at least not yet.”
For some patients, pumps are not a matter of choice.
Saskatoon resident Tristan Banyay’s blood sugar rises in the early morning, like many people’s — but because his pancreas can’t produce insulin to counteract that surge, he sometimes wakes up vomiting, sick and needing urgent medical care. The pump prevents that — except for the odd time when Banyay has accidentally blocked the tube while sleeping.
Opposition health critic Vicki Mowat is concerned the out-of-pocket cost puts low-income patients at a disadvantage. She believes the long-term costs of hospital visits and potential complications — like organ failure, amputations and blindness — will cost more than providing pumps.
“You look at all the costs down the road, it’s a no brainer,” Mowat said. “Diabetes leads to so many other complications when it’s not managed.”
Banyay, who turned 26 this month, said if nothing changes in five years he plans to move to Alberta, which covers the pumps for everyone — along with B.C., Ontario and the territories.
“At this point, why would I put myself through all of this if I can just move next door?” Banyay said.
Kuspira is also considering moving. He doesn’t know what he’ll do when his pump inevitably stops working, he said.
“This sounds weird, but I really don’t have a Plan B if it fails. I don’t know what I’d do.”
zvescera@postmedia.com
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