Proposal dismays hi-tech users
Pharmac’s plans to roll out insulin pumps and blood sugar monitors for 18,000 New Zealanders have come with a shock in the fine print for 2000 people with Type 1 diabetes whose funding for hi-tech systems will be cut.
Palmerston North resident Marika Harvey said the news that their Medtronic pumps and accessories would not be paid for after October, a change buried at the end of an announcement just before Easter, was “cruel”.
She has started a petition opposing the cuts, which has already gathered more than 3681 signatures.
Harvey, who was diagnosed with late-onset Type 1 diabetes five years ago, said the system she was using at the moment allowed her to live almost normally.
At first, she was having to do finger-prick blood glucose tests up to 20 times a day, and injecting insulin.
She tried one of the systems now proposed to be funded, which enabled constant monitoring and insulin delivery but was not so sensitive and required manual intervention.
Harvey remembered the date, February 22, 2023, when she moved to the Medtronic insulin pump Guardian 4 hybrid closedloop system.
“That day changed my life.”
It was the first time since diagnosis that her blood sugars were steady at a level that would be considered normal in pre-diabetes, and they had remained stable since.
Equipped with the monitor on her arm and pump unit on her stomach, she came close to being able to set and forget, confident that the monitor was constantly sending signals to adjust her insulin doses.
Instead of being tied to a regimented lifestyle of checking and adjusting, and preparing for changes in activity level and meals, she had the confidence and freedom to be spontaneous, such as playing with any of her three children when the moment was right. It was as close as she could imagine to having a working pancreas.
The monitor only needed changing once a week, the stomach patch was good for three days instead of one, the insulin reservoir was big enough to last several days, the battery was good for a month, and while a phone was a useful part of the system recording what was happening, it was not essential to keep it close at hand all the time.
Its particular strength over other systems was the way it learnt about an individual’s patterns and needs and adjusted to them.
“For many of us, access to this technology is not just a convenience but a lifeline, enabling us to live fulfilling lives and stay as healthy as possible for as long as possible.”
Harvey said if Pharmac’s plan went ahead, people would have to change over to inferior systems, or pay $10,000 every four years for a new one, plus $140 a week for consumables.
For many, that was not financially viable, and she said people were distraught at the prospect of having to learn to use a different system that would give them less control and require more intervention.
She said she could not understand why Pharmac would remove access to the most advanced technology available.
Any savings would be negated by the risks of serious health problems for people with poorly-controlled diabetes, including blindness, kidney failure, heart disease and increased susceptibility to infections.
“But what may not be as obvious is the profound impact these pumps have on our mental health.
“It allows us to live fulfilling lives and focus on our goals and aspirations without constantly worrying about our health.”
Diabetes New Zealand welcomed the Pharmac proposal to fund monitors, pumps and consumables for everyone with Type 1 diabetes as a historic milestone.
The organisation said in a statement the proposed changes would be causing concern and anxiety for those using Medtronic pumps, and urged them to provide feedback and seek support from them or their clinical support teams.
Pharmac pharmaceuticals director Geraldine MacGibbon said all feedback on the changes was welcome, particularly from people who wanted to explain the impact moving away from MiniMed to another pump would have.
The aim was to meet a significant need among people with Type 1 diabetes within the budget available, providing monitors for all of them, and suitable pumps for those eligible.
Up to 10% of people would be able to access a different product if their prescriber considered the funded products were not suitable.