In August 2013, the Ontario provincial government changed their health policy to restrict test strip reimbursement for people with diabetes. Those who are not dependent on insulin therapy will only be reimbursed for 400 test strips a year, while those dependent on insulin therapy will be limited to 3000 strips a year. The change, policymakers said, was evidence-based, but the Canadian diabetes community has protested the restriction as a penny-pinching move that could adversely impact thousands with diabetes.
Columnist Alyssa Tangerine recently penned an open letter to Ontario Health Minister Deborah Matthews in protest of the test strip restrictions. The edited version is below. Consider it as a template if you need to write a similar letter to policymakers in your state or province:
Dear Minister Matthews,
I want to share my experience on how the new test strip policy change to Ontario’s Drug Benefits program has affected me in recent weeks. It has been an extremely frustrating experience and I feel it is important for you to know what people with diabetes in Ontario have to deal with because of this changed policy.
As a resident of Ontario, I feel very lucky to live in a province that recognizes the financial burden that people with chronic illnesses face. Programs like the Assistive Devices Program and Trillium Drug Benefits help me to better manage my diabetes by covering some of the hefty costs associated with the many daily supplies I require to live. I have been living with Type 1 diabetes for just over 16 years and work extremely hard each day to manage my blood sugars and stay healthy. The change that occurred on August 1 2013 to the quantity of test strips that Trillium will cover for people living with Type 1 diabetes is disheartening and alarming.
In previous years the coverage for test strips was unlimited; now it has been restricted to only 3000 per year, which breaks down into 8 test strips per day. As person who lives with this chronic illness I am trying to understand the reasoning behind a change like this. There are many supplies that I require just to stay alive, but test strips are the one basic item that I must have. My entire diabetes management is based off a number that appears on my blood glucose meter after I test. Also, current blood glucose meters on the market have a variance rate of up to 30%, meaning that the readings that appear are not always accurate. The insulin pump, an amazing technology that has transformed my life with diabetes, again is a piece of technology that does not always work perfectly. The only way to ensure true accuracy is to test, and then test again.
Now I only have 8 test strips to use. That means if I feel sick one day or my blood glucose meter is off or maybe I just did too much walking…all of these things that are part of life have to now fit into 8 tests. These examples do not even touch on the fact that fluctuations in our blood sugar happen all the time without reason.
It was not until this past month when I realized how much this change was going to affect my life. When I went into my local pharmacy to pick up my test strips they told me that I had used up all of my strips for the Trillium calendar year and that I would have to pay out of pocket until the new year started in August. For me this means at least $250 per month that I will now have to pay out of pocket, since I have no drug plan with my job. That is a large amount of extra money I need to find in my budget to literally keep myself alive.
After hearing this, my first step was to call Trillium. I needed to hear for myself that I had in fact reached my maximum for the year. Trillium representatives verified this and told me that my only option was to get a written letter from my doctor stating that I needed to test more than 8 times a day; this would allow me a maximum of 100 extra strips, which maybe would last an extra 10 days.
At this point I decided to call government health officials to not only express my feelings about this change but to find out what else I could possibly do. The people I spoke with advised me not to worry and that if I needed more test strips that I could get as many as I needed. All I had to do was visit my doctor, get a prescription stating I need ‘x’ amount of test strips per day, and list a medical reason why. Then I should ask my pharmacy to request the override code the next time they placed an order in their system for my strips.
It didn’t work. The next time I went in to get my test strips I learned Trillium would only give one more box per prescription. Each time you need another box, you have to go back to your doctor, get another note and repeat this process (How is this a smart use of scarce health dollars?).
Now here we are today and I am writing you this letter, as I do not know what else I can do at this point. I am asking you to please reconsider this policy change. Discouraging people from proper diabetes management is only going to put a bigger financial strain on our health care system. Allow people the most basic item that they need in order to live healthy with diabetes.
I truly appreciate your time and would be happy to discuss my position on this topic with you further.
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