Canada’s Di­a­betes Epi­demic

Policy - - In This Issue - Kim­ber­ley Han­son Di­rec­tor of fed­eral af­fairs at Di­a­betes Canada

For years now, a huge cri­sis has been grow­ing, seem­ingly un­no­ticed by many of us—the di­a­betes epi­demic. One in five Cana­di­ans has been di­ag­nosed with di­a­betes, and one in three have ei­ther pre­di­a­betes or di­a­betes now. Costs to Canada’s health-care sys­tem are ris­ing at a rate of about 40 per cent per decade, top­ping $27 bil­lion in 2018 and show­ing no signs of slow­ing.

And at the same time as the rates of this chronic dis­ease are sky­rock­et­ing, ex­ten­sions to the ‘data pro­tec­tion’ pe­riod for some medicines un­der the USMCA may in­flu­ence their pric­ing. The architects of a na­tional phar­ma­care ap­proach cer­tainly have their work cut out for them as they tackle the many is­sues fac­ing Cana­di­ans re­quir­ing ac­cess to ef­fec­tive and in­no­va­tive ther­a­pies.

To be clear, about six mil­lion Cana­di­ans have di­a­betes, and when Cana­di­ans with pre-di­a­betes di­ag­noses are in­cluded, the num­ber of Cana­di­ans liv­ing or threat­ened with di­a­betes rises to 11 mil­lion. To put those num­bers in the con­text of our gov­ern­ment, that equates to 113 of our 338 Mem­bers of Par­lia­ment hav­ing pre­di­a­betes or di­a­betes. That’s as many as ev­ery sit­ting mem­ber of Par­lia­ment who is not Lib­eral or NDP. Or two-thirds of the Lib­eral cau­cus.

Di­a­betes claims thou­sands of Cana­dian lives and dis­ables tens of thou­sands more each year. It af­fects Indige­nous Cana­di­ans far more ad­versely. What we are do­ing now to ad­dress this epi­demic is, quite sim­ply, not work­ing.

But, just as gov­ern­ment has played a crit­i­cal role in ad­dress­ing other health and nat­u­ral crises, so can it play one in com­bat­ing di­a­betes—by em­brac­ing a na­tion-wide strat­egy called Di­a­betes 360˚. De­vel­oped in col­lab­o­ra­tion among 120 stake­hold­ers, in­clud­ing nine pro­vin­cial gov­ern­ments, Di­a­betes 360˚ con­tains ev­i­dence­based rec­om­men­da­tions aimed at im­prov­ing pa­tient out­comes. It will en­hance the preven­tion, screen­ing and man­age­ment of di­a­betes to achieve bet­ter health for Cana­di­ans. It will re­duce un­nec­es­sary health care spend­ing by bil­lions of dol­lars, im­prove the lives of mil­lions of Cana­di­ans and pro­tect Canada’s pro­duc­tiv­ity and com­pet­i­tive­ness.

Di­a­betes Canada rec­om­mends that in Bud­get 2019 the fed­eral gov­ern­ment should es­tab­lish a na­tional part­ner­ship and in­vest $150 mil­lion in fund­ing over seven years to sup­port the de­vel­op­ment and im­ple­men­ta­tion of the Di­a­betes 360° frame­work. Con­cur­rently, the fed­eral gov­ern­ment should fa­cil­i­tate the cre­ation of Indige­nous-spe­cific strate­gic ap­proaches led and owned by Indige­nous groups.

Di­a­betes 360˚ can save our health-care sys­tem bil­lions of dol­lars in the short- and long-terms. For ex­am­ple, if ev­ery Cana­dian who has pre­di­a­betes had ac­cess to the proven Di­a­betes Preven­tion Pro­gram, we could pre­vent more than 100,000 Cana­di­ans from re­ceiv­ing a di­ag­no­sis of di­a­betes ev­ery year. If we im­prove the care that those al­ready liv­ing with di­a­betes re­ceive, re­search shows we could pre­vent a min­i­mum of 5,000 am­pu­ta­tions and 35,000 hos­pi­tal­iza­tions each year. That would save our health­care sys­tem $18 bil­lion in the next decade alone.

There are also sig­nif­i­cant sav­ings to be re­al­ized by Cana­dian busi­nesses. Ac­cord­ing to Ben­e­fits Canada, em­ploy­ees liv­ing with di­a­betes cost their em­ploy­ers an av­er­age of $1,500 per year in lost pro­duc­tiv­ity. And an­other $1,500 per year in ex­tra ben­e­fit plan costs. Pre­vent­ing those 100,000 Cana­di­ans per year from de­vel­op­ing di­a­betes will save Cana­dian busi­nesses a fur­ther $18 bil­lion in the next decade.

Canada’s eco­nomic pros­per­ity de­pends on a healthy work­force. Yet we know that the ef­fects of liv­ing with this chal­leng­ing dis­ease im­pede the abil­ity of those with di­a­betes to fully par­tic­i­pate in the work­force. For em­ploy­ees who must take dis­abil­ity leave be­cause of their di­a­betes, the leaves are on av­er­age 15 per cent longer in du­ra­tion, and many re­main on dis­abil­ity un­til death. Im­ple­ment­ing the Di­a­betes 360˚ rec­om­men­da­tions can help en­sure Canada’s eco­nomic health at the same time it en­sures our phys­i­cal health.

Canada has a proud his­tory as an in­no­va­tor in di­a­betes in­clud­ing, Dr. Fred­er­ick Bant­ing’s dis­cov­ery of in­sulin in 1921. The 100th an­niver­sary of this dis­cov­ery is fast ap­proach­ing, and by sup­port­ing Di­a­betes 360˚, Canada can re­take a lead­er­ship role in the fight against di­a­betes.

For a strate­gic in­vest­ment of $150 mil­lion over seven years, the fed­eral gov­ern­ment can achieve at least $36 bil­lion in cost re­duc­tion, en­sure the fu­ture health and pros­per­ity of Cana­di­ans and truly make a dif­fer­ence for all Cana­di­ans af­fected by di­a­betes.

That’s just good pub­lic pol­icy.

At the same time as the rates of this chronic dis­ease are sky­rock­et­ing, ex­ten­sions to the ‘data pro­tec­tion’ pe­riod for some medicines un­der the USMCA may in­flu­ence their pric­ing. The architects of a na­tional phar­ma­care ap­proach cer­tainly have their work cut out for them as they tackle the many is­sues fac­ing Cana­di­ans re­quir­ing ac­cess to ef­fec­tive and in­no­va­tive ther­a­pies.

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