The Barriers to Insulin Pumping in Australia

Decision day for the pump is fast looming. To Pump, Or Not To Pump? One resource that I finally got around to reading was a PDF created by Diabetes Australia titled Insulin Pump Therapy in Australia: The Case for Action. It’s well worth a read, check it out here.

Since I was diagnosed five years ago, I’ve attended a Diabetes Clinic in a Public Hospital. I’ve had free access to all of my diabetes specialists there, and I really have nothing to complain about. I’ve managed my diabetes on Multiple Daily Injections ever since, and I never really knew any differently.

I’d heard of insulin pumping. I knew it was expensive. I can’t say I completely understood the concept. In my world back then, it seemed fairly uncommon. I thought that it was something for people who were struggling with their diabetes management. My diabetes care team never really suggested, or encouraged insulin pumping as an option for me.

It wasn’t until finding the Diabetes Online Community last year that I really began to consider insulin pumping as an option for my diabetes management. I began connecting with many others who were using insulin pumps. I read their stories about them. I saw how significant a part pumping played in their diabetes management. I read the all of the news reported on diabetes technology, and I realised what a big deal insulin pumping was in the diabetes world. I even found myself compelled to write about and advocate for technology that I wasn’t even using.

Reading that PDF today, I’m not surprised to see that only 12% of Australians with type 1 diabetes have access to insulin pump therapy. I need only look at my own situation to see how many barriers there are towards switching from Multiple Daily Injections to an insulin pump.

My healthcare professionals have never suggested, or encouraged me to consider insulin pumping in the five years that I’ve lived with diabetes. Sure, I was diagnosed as a young adult. Sure, on paper my chart is probably among the cream of the crop. My endo told me “this is the best I could hope for” as her patient. But that doesn’t mean I wouldn’t see benefits from insulin pumping. I’d like to bring my hba1c down further, because my diabetes isn’t getting any younger. I’d like better stability overnight without having to pour my blood, sweat and tears into doing so. I would love to be able to eat more spontaneously when the occasion calls for it, and be less stressed about doing so. However, it was me who had to spark this ignition towards considering an insulin pump.

I could qualify for a pump through the Australian Government’s Insulin Pump Program. This program would subsidise up to 80% of the total cost of an insulin pump. However, funds from this program are being allocated towards the cost of pump consumables, despite their availability at a subsidised cost through the National Diabetes Services Scheme. The end result is that my chances of being allocated funds for a pump would be significantly lower. And because I am over the age of 18, I wouldn’t qualify for a pump as my need for one is considered secondary to those younger than me.

So, thank goodness for my Private Health Insurance, right? They will cover the cost of an insulin pump of my choice. However, in order to get my private health insurance to pay for the pump, their policy dictates that I stay in hospital. Which means that I have to find a hospital bed which so many others are in genuine need of, when the pump could easily be administered in a clinic setting.

Then, if my pump malfunctions outside of it’s warranty and within the next four years, I will have to bear the cost of a replacement. Why? Because my private health insurance will only provide a benefit once every four years.

Finally, if I do choose to switch to the pump, there will be at least a three month wait. I’m in a public hospital diabetes clinic where there are more patients than there are resources and time. As a patient, I was quickly weaned off of diabetes education as soon as I was able to manage things on my own. Where pumping is concerned, a block of four consecutive education sessions won’t be available for three months. Which sucks when I’m at a stage where I’m absolutely sick of Multiple Daily Injections and ready for a fresh start.

Seriously, I love our health system here in Australia. But surely it’s time that we cut some of the red tape.

 

3 thoughts on “The Barriers to Insulin Pumping in Australia

  1. I got a pump four years ago after 40 odd years of injecting. It is fantastic. I bypassed the whole system and went direct to the medical representative, they were great, gave me contact details of professionals who were up to date on acquiring a pump. In WA i bet you have an endo or two who will do it as a day patient, but you will need private health insurance for that, at least hospital cover.

    I am an activist for technology and equality in healthcare, just realistically speaking, with this government it is not going to happen. All we will get is realignment of funds, just like the sub group who get CGM subsidised, whilst simultaneously the gov cuts $40 million from NDSS and approves second rate biosimilar insulin!

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