Loss Of Choice

[WHM]

Had a DAFNE update meeting yesterday in Hull and was told that as from this week there will only be one pump available for patients in Hull & East Yorkshire- the Roche Insight. Previously we had a choice of 4 including two patch pumps Omnipod and in my case Cellnovo.
Apparently the finance department here has decided that too much is being spent on pump therapy and costs must be reduced. Roche have offered the Insight at a cost way lower than the others are changing. One of the diabetes team did ask if patients may be able to pay the difference between the Insight cost and that of their preferred choice, no answer on that as yet I suspect they will probably say no.
Very disappointed by this one of the main reasons I chose the Cellnovo was because I could read the screen in bright conditions which I was unable to do with the Omnipod or Animas pumps I have used previously, I spend a lot of time outdoors, I understand the Insight screen isn’t very visible in sunlight. Also much prefer a tubeless pump.
Anyone else facing the same withdrawal of choice?

 

[kitedoc]

In Australia we are fortunate to have choice of 3 pumps either via restricted public health option or use of private health for those that can afford it !!
But I note that Roche withdrew its insulin pumps from the US market in 2017 without any explanation and I could not find how advanced plans were for their own CGM. So CGM options seem a little up in the air.
I could not find any reliable data on rates of pump failure, pump recalls and other notices etc between brands to help you.
Money unfortunately speaks louder than common-sense sometimes.

 

[Cobia]

In Australia we are fortunate to have choice of 3 pumps either via restricted public health option or use of private health for those that can afford it !!
.

According to DA. The restricted health system in aus could be only via gold tier private health insurance.

Quote from diabetes Vic email.

Diabetes Australia and members of the Type 1 Diabetes Alliance (Diabetes Australia, JDRF Australia, the Australian Paediatric Endocrine Group, the Australian Diabetes Society, and the Australian Diabetes Educators Association) have reacted strongly to proposed public health insurance reforms which will see insulin pump therapy only covered in the Gold Tier of private health insurance (PHI).
The letter looks like its sent to the health minister.

I hope both countrys come to thier senses.

 

[kitedoc]

According to DA. The restricted health system in aus could be only via gold tier private health insurance.

Quote from diabetes Vic email.

Diabetes Australia and members of the Type 1 Diabetes Alliance (Diabetes Australia, JDRF Australia, the Australian Paediatric Endocrine Group, the Australian Diabetes Society, and the Australian Diabetes Educators Association) have reacted strongly to proposed public health insurance reforms which will see insulin pump therapy only covered in the Gold Tier of private health insurance (PHI).
The letter looks like its sent to the health minister.

I hope both countrys come to thier senses.

Thank you @Cobia, I have heard of this threat too but was reporting the status quo. There has been an argument (unable to remember the source to reference it) that use of CGM of some form plus frequent use of insulin via new insulin pens with 1/2 unit gradations produced equally good BSL control as an insulin pump. Of course we know that HBA1Cs are a poor comparator.
I query that report very strongly as to the length of the study, (not reported as i do recall) and the ability to maintain equivalent control long term (how long is someone going to continue to wake up at say, 4 am to 'dribble in' insulin via a pen to combat the Dawn Phenomenon)? And whilst pump consumables obtain Government subsidy for all T1Ds pumpers under 18 years of age, those who are pregnant and require an insulin pump are excluded from such subsidy. As we say in Oz, "What the .....?"
However fiancialists (my term) can sniff out an economic advantage from a mile off and the Aussie health system economists follow in a trampling rush. Stupidity at its finest. I hope that commonsense will prevail.
The current scheme of pump supply via public health here is too slow and restrictive (it is reported) to supply all who currently qualify and one could cynically conclude that this is deliberate in order to force patients to take out and use private health insurance to supply their pump.
So if I have it correct at present NHS has restrictions via pump choice and strict criteria, and presumably persons can obtain private insurance to fund a pump presumably with consumables cost covered or ? self-fund, compared to Oz where restriction of numbers of pumps offered via Medicare, pressure for use of private insurance (with restrictions based on clinical grounds plus ability to pay top tier premiums with subsidised consumables. Self-fund might be posible but again darned expensive !!
Economy and short-sightedness economically rule the roost.
\New thought: develop a treatment which will render economists and Health Ministers insulin dependent for 3 months. Repeat for whatever health condition is under the economic hammer eg renal failure, COPD etc.

 

[EllieM]

\New thought: develop a treatment which will render economists and Health Ministers insulin dependent for 3 months. Repeat for whatever health condition is under the economic hammer eg renal failure, COPD etc.

Nice, but 6 months would be better

 

[kitedoc]

Nice, but 6 months would be better

Ha ! Ha ! Was I being too kind ??