DIABETICS PAN REDUCED COVERAGE FOR TEST STRIPS
Reduced coverage for blood test strips burdensome for 82-year-old mom, son says
A Regina man is angry about the reduced coverage for blood glucose test strips that diabetics receive under the provincial drug plan.
Rick Hofenk’s 82-year-old mother, Petronella Hofenk, has been a diabetic for 56 years.
Petronella isn’t on insulin, but tests her blood sugar on average four times a day.
“When I’m active, I have to check more often,” she said.
All diabetics in the province were allowed 10 strips a day or 3,650 per year, but that changed in 2015.
The limit of 10 strips a day continue to be available for diabetics requiring insulin.
But those managing diabetes with medication and who could be at higher risk of it causing low blood sugar have a limit of 400 strips per year. And those at low risk of low blood sugar are limited to 200 strips annually.
Petronella is covered for 400 test strips per year — slightly more than one a day.
Test strips are a benefit under the Saskatchewan Drug Plan, but coverage varies, said Dave Morhart, executive director of the Drug Plan and Extended Benefits Branch with the Ministry of Health.
“They’re just basically treated like other drugs so some people may have full coverage, others may have 50-per-cent coverage whereas others may have no coverage,” Morhart said.
“It’s an income-tested program.” The changes were made to align with Diabetes Canada evidencebased guidelines for blood glucose testing, he said.
“With those guidelines, the approved quantities are based on an individual’s diabetes treatment plan and really may vary from patient to patient,” Morhart said.
Prices range from $55 to $104 for 100 strips, according to the Ministry of Health.
Depending on where she buys them, Petronella pays about $75 for 100 strips.
“If I get the support, I pay $25,” she said.
Also a diabetic, Rick is allowed 200 strips a year.
“The doctor decides how much medication I take so the doctor should decide how many strips I need,” he said.
He and his mother have contacted the ministry numerous times about increasing coverage for test strips.
Morhart can’t speak to specific cases, but said if individuals need to test more frequently, they should consult their health-care providers.
Petronella’s family doctor wrote the drug plan asking for an exception so she could receive more than the approved quantity of strips. The request was denied. Increases of 100 strips a year can be provided if an individual is in an occupation that requires strict avoidance of low blood sugar for safety reasons, such as pilots or commercial drivers, Morhart said.
Other exceptions include individuals who don’t meet glycemic targets determined by their doctor for three months or longer, gestational diabetes, changes in drug therapy that might impact blood sugar control, acute illness or infection.
“For those who require more than 100 additional strips, the ministry will consider these requests as well on a case-by-case basis,” Morhart said.
“It really has to be supported by the clinical judgment of the physician or the health-care provider and the appropriate medical evidence.”
In 2017-18, almost 28,000 Saskatchewan residents had partial or full coverage from the drug plan for their BGTS. The ministry doesn’t have information about purchases made through retail stores or under private insurance plans.
Rick said his mother is on a fixed income and can’t afford to pay $900 to purchase extra test strips for the rest of the year.
“What about all of the rest of the people who fall under the same category as my mom?” he asked. “There will be lots of them who say ‘I can’t afford it therefore I’m not testing.’ Their health is going to go down the tubes and we’re going to have more problems with diabetics.”
He wants the government to admit the changes were made as a cost-cutting measure.
Changes to the approved quantities were not made for budget reasons, but implemented to promote appropriate use of test strips in accordance with Diabetes Canada guidelines, according to the ministry.
“If these guys think we like pricking needles in our fingers four or five times a day, they ’re crazy,” Rick said. “We don’t do this because we enjoy it, we do it to keep our health in good order.”