I posted on Facebook last month about my quest to get Medtronic’s “hybrid closed-loop” pump, the 670G.
My original post was intended to be about how much it costs to be a healthy Type 1 diabetic in this age of for-profit healthcare. (Or Type 2, for that matter, but since I’m a T1, that’s what I know.) The backstory is that I currently use a Medtronic insulin pump. I have used their pumps since I started insulin pump therapy back in 2001 and have always been very happy with them. (My current insurance company only covers Medtronic pumps, but that’s a topic for another time.) My warranty is not up yet on the current pump – it doesn’t expire until December 2018. I will have different health insurance (at least I hope to have health insurance) starting July 2018.
So, my dilemma is this: My endocrinologist thinks the Medtronic 670G pump would be very beneficial to my diabetes care. I currently use a Dexcom CGM (continuous glucose monitor) and a Medtronic Paradigm insulin pump for my diabetes management. She thinks that the 670G will work very well for me in particular. It is known as a “hybrid closed-loop” system and has its own sensors that communicate with the pump. (You can learn more about it here: http://www.medtronicdiabetes.com/home .) In my case, she thinks that it will help the areas I have trouble getting my blood sugar in range. Let me be clear about that too – my struggles in this area are not any fault of mine. I’m about as proactive as they come. Every T1 will tell you that they have problem times of the day or have hypoglycemic unawareness or some other issue that no matter what you do, you can’t get the results you want.
My doctor is a big advocate of treating the patient’s needs, meaning she looks at all the treatment options available for her patients and matches the system or protocol that she, along with her patient, decide will have the best outcome for said patient. What a concept! The doctor and patient decide what to use to treat the patient effectively! I am not eligible yet for my insurance to cover a new pump (oh, plus my copay – I don’t ever get it for free). I do qualify for Medtronic’s Pathway program though, which would let me get the new pump, but I would pay $3,100 out of pocket up front. That’s big money. What to do, what to do.
I lamented this in a Facebook post on my personal page. It wasn’t really about me or my ability to afford or not afford this particular pump. So far, I have been lucky in that I have always had the means to take care of my diabetes. What I really was talking about is how expensive the wonderful technology that is available today to treat diabetes is, but how does your average American afford it? Even with my insurance covering a new insulin pump, I wind up paying hundreds of dollars in copays plus copays monthly for the supplies. My post had everything to do with manufacturers and pharmaceutical companies charging really whatever they want for their products with no regulations on how much they can raise prices or how often.
Sadly, my post got hijacked and it turned into a shouting match about “Obamacare” being the culprit for high insurance costs. I never brought up the ACA or Obama, or Trump, or even insurance premiums for that matter. (For the record though, I don’t subscribe to the thinking that the ACA is the culprit for high insurance prices – another topic for another post.) My topic got completely lost and that’s the real shame here, because we as a country urgently need to address these companies and the prices of devices, treatments, and medicines and the lawmakers who take campaign money from those companies, and what their part in these out-of-control prices are. (That last one is yet another topic to be tackled at a later date!)
The thing that really bothered me though is that one person accused me of wanting “the Lexus” of insulin pumps for the same price as “the Nissan” of pumps that I already have – their analogy, not mine. Do people really think like that? I was so disgusted by that remark that I just dropped out of the discussion. By the way, no one bothered to ask me how much I paid out of pocket for the current pump I have or how it compared to the cost and usability of the “fancy” one. That comment really upset me. It got me wondering if this is what people at large really think or was this just the rantings of a grossly uninformed troll looking to stir things up? I truly hope it is the latter.
The reality is that pump therapy has not changed all that much, at least since I’ve been using one, (17 years if you’re counting). This closed-loop system has been around for a long time. Have they worked out some bugs and are they better? Of course they have and yeah, a little. All pump companies are offering some system like this or it’s in the works. None of them are that different either. To add a bit more clarity and illustrate how uniformed that “Lexus” comment really is, it’s not that the current pump I have is worse in any way. The 670G has some features that, up until now, I haven’t really been all that interested in. If my endocrinologist thought the current treatment plan we have was the best one available for me, I wouldn’t be trying to figure out how to get the 670G. For example, my 12-year-old daughter currently uses the same management plan as I do right now: Medtronic Paradigm pump and Dexcom CGM. And that system is working very well for her. Neither her doctor, nor I, think that the 670G would be the best option for her at this time. It’s not an issue of newer models “should” cost more. That thinking disgustingly illustrates my point of for-profit healthcare not having the patient’s actual health and well being as its main objective. It’s really a question of what works best for the patient and that these options are affordable for all patients. At some point, the pump I have will not even be available anymore and I’ll be forced to get a different one and a different management plan whether I like it or not. Insulin pumps are expensive. All of them. The prices of these things keep going up and up and again, why are they so insanely expensive?! (It’s not money for R&D, so don’t even go there – yet another topic for another post!)
So, again, how does your average American afford this? And does the rest of the country, who doesn’t know anything about treating Type 1 diabetes, really think we are all greedy in wanting something that will improve our care? I mean, why aren’t we all still boiling glass hypodermic syringes and sharpening the needles by hand if that’s the case? Come on people, diabetics die or get serious complications if we don’t treat this disease effectively – one we had no part in getting, by the way. There are options available now for us to have better care, which means better outcomes, better quality of life, and less complications. If these treatments and devices were more affordable, it would mean less people who cannot currently afford to treat their diabetes the way they and their doctors want to winding up in emergency rooms and less people needing extensive and invasive treatments as well – which is cost savings across the board for everyone. It’s really not that difficult of a concept.
