The Right to Choice in Diabetes

On referendum day last week, as people were voting, I tried to keep myself off twitter and lower my anxiety levels by catching up on diabetes blog reading.Over the last two months in Ireland the right for a woman to choose what happens to her body has been the main topic of conversation and I, like so many others, was personally invested in the outcome of this referendum. So it wasn't surprising then when I read about the launch of a new insulin pump in Australia last week that I started to think about my choices in diabetes tools and treatments, especially in insulin pumps in Ireland.

At the moment, in Ireland, we only have one insulin pump company serving the community. And as an Animas Insulin pump user with a warranty that expires month, I was a tad jealous to hear that another country was getting an additional choice while we are in such limbo.

What is the state of play at the moment with new pump choices?

 Photo Credit DiabetesDad.org These devices are all insulin pumps.

Photo Credit DiabetesDad.org These devices are all insulin pumps.

INSULIN PUMPS - NO CHOICE (AS OF APRIL 2018)

Before I go ranting off, I do know that we are luckier that most because we have a government who provides us with the absolute necessities to stay alive with diabetes but that doesn't mean we should be excluded from choices or better treatments/devices simply because they cost more. The “cost” needs to weight against the health benefits AND our quality of life value.

Since the exit of Animas from industry, we currently have only one company providing insulin pumps in Ireland. The Irish health service invited tender applications for a new pump contract last November but we have no further communication beyond this from the health service. We don't know how long it will take to decide or make an announcement on the new contract and if it will be to one company or multiple companies. Not only that but the companies who applied to be considered are forbidden from contacting the health service for any updates also. (!!!!!) 

I’m rooting for multiple companies for competitive fairness and to encourage increased engagement with the patient community to serve their customers better.

 

WHY CHOICE IS IMPORTANT FOR ME?

There are huge disadvantages to only having one insulin pump company serve our community. We need choices because all insulin pumps are different and I need to be able to choose the one that works best for me. Not just the insulin delivery part but the easy to use factor and the easy to wear factor. This device is attached to me 24 hours per day so it is hugely important that it is comfortable to wear and easy to use.

We also need choices because if we don’t have choices then manufacturers don’t have to be competitive in pricing (see below on insulin choices), don’t feel compelled to make improvements to the products and definitely don’t have to listen to their users.

Here’s a list of insulin pumps we DON'T have in Ireland:

  • Tandem T-Slim
  • Omnipod
  • YpsoPump
  • Medtrum patch pump
  • Roche Accu-Chek Combo
  • Cellnovo
  • Sigh!!! :-(

Insulin Pumps available in Ireland at the present time:

  • Medtronic 640G
  • MiniMed Veo
     

THE CHOICES WE DO HAVE

Blood Glucose Meters - Loads of Choices

When it comes to blood glucose meters I have so many choices. They all do so many different things, some come with Apps, some with wizard tools and switching is easy. We have Ascensia, Accu-Chek, OneTouch, Freestyle, TrueResult, and so many more.

There is one to suit every person with diabetes and their needs. 

Insulin’s - Some Choices

There are a few of choices of modern fast acting insulin and a few choices for long acting insulin. So choice here is limited because not many companies in the world manufacture it, oddly, given the huge profit margin it has in some countries. Yes I’m talking about you, the disfuncional and ridiculous American healthcare system.

Ultimately, I can experiment with all of these insulin’s to find the combination that works best, so the choice of insulin’s is fairly good.

Insulins 2018-05 copy.png

 

Continuous/Flash Glucose Monitors - Some Choice … if you can afford it.

This might be a little contentious because a lot of these choices are dependent on being able to afford them. If you can’t afford any of these devices financially then you have very little choice because The Irish health service decides if you should get one or not.

However, if you can afford any of these you have the choice of three devices with possibly two more companies coming into Ireland soon.

See more here on CGM Funding Options

 

Waiting Patiently

For now I am waiting patiently on news from the Health Service and continuously contacting the insulin pump companies even though I know they will be the last to be informed. However, I am sitting on an email address within the health service to contact for more information and I don't think I'm excluded from doing so as a concerned consumer!!!!