Canada’s Diabetes Epidemic

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.