Acquiring glucose supplies should not be nearly this hard

As we emerge from the COVID-19 pandemic, we need to rethink all aspects of our health care system.

It is easier for my patients to get marijuana than it is to get diabetes supplies. I am a primary care physician who cares for a mostly Medicaid population. In Connecticut, to certify a patient to receive CBD-related products, a physician enters the patient’s information into a state-sponsored website and attests to an underlying chronic condition. That’s it. The certification is good for one year. The patient can present to any statelicensed dispensary for a consultation.

When I last ordered a glucometer, test strips, needles and lancets for a patient with diabetes, the pharmacy sent back paperwork to be filled out. Some brands are covered by certain insurance companies, other brands are not. Some pharmacies require paperwork to be filled out with their last primary care visit and glucose results. Some medical supply companies require a paper script. They all require proper documentation of diagnosis codes. Requirements seem to change monthly. This causes a needless backand-forth of paperwork that causes disruptions in care. This happens all the time.

Make no mistake, the administrative hassle has real consequences. The other day, a patient presented to my clinic with a glucose reading of 400. The reason? She could not pick up her glucometer and, appropriately, did not feel comfortable giving herself insulin. There were many potential reasons for this breakdown in care. The glucometer was not covered (it was). The paperwork had not gone through (it had). And on and on.

This situation is reflected at a national level. Ten percent of the American population has diabetes. One-half of people with diabetes have trouble picking up diabetes supplies, citing the expense and administrative hassle. Approximately one-half of diabetes patients have poor glucose control. One in four health care dollars is spent treating diabetes, with an annual cost of more than $327 billion per year. We need to do better.

For years, I have thought the problem was my fault. In my informal survey of patients and colleagues, this is not true. We are all struggling. A 2018 survey by the American Medical Association of 1,000 physicians revealed that 91 percent believe that administrative hassles “have a negative impact on patient clinical outcomes.” Seventy-five percent of physicians said the requirements “can at least sometimes lead to patients abandoning a recommended course of treatment.”

There are many roadblocks to this administrative labyrinth. But is in the interest of everyone — patients, providers and insurance companies — to streamline this process. We have done this before, such as with state-licensed marijuana dispensaries. Plan B, the so-called morningafter pill, is affordable and available without a prescription. We rolled a massive, complex COVID-19 vaccine distribution system with reasonable efficiency.

We need to do the same for diabetes supplies. The solution is simple: diabetic supplies should be readily available to anyone with diabetes, no prescription needed. These supplies should be covered by insurance without issue, or free to those without insurance. Everyone will win. The reduced administrative burden will streamline efficiency, increase access, and thereby reduce costs and improve care.

As we emerge from the COVID-19 pandemic, we need to rethink all aspects of our health care system. Acquiring glucose supplies should be just as easy in Connecticut as acquiring marijuana.

File photo The solution is simple: diabetic supplies should be readily available to anyone with diabetes, no prescription needed. These supplies should be covered by insurance without issue, or free to those without insurance.