Access to insulin pump program expanding

MONCTON – The provincial government is making insulin pump devices and related supplies more available and affordable for New Brunswickers living with Type 1 diabetes.

In addition, the Department of Health will soon offer coverage for continuous glucose monitoring and will move to a payer-of-last-resort model for these two programs.

“We are pleased to take these steps to expand access to the insulin pump program, as we recognize the financial hardships families affected by diabetes can face with regards to treatment,” said Health Minister Bruce Fitch. “As a result of these updates to the program’s framework, we are expecting the number of clients accessing pumps and supplies to nearly double.”

“This is the first step in an additional $2.1 million investment towards better diabetes management, which will lead to fewer complications, reduce hospitalizations, and lead to all-around better health,” he said.

Insulin pump therapy is an alternative to other forms of treatment, like multiple daily injections, for people living with Type 1 diabetes. For many, the pump program offers an improved quality of life.

Previously, the program provided coverage, based upon income, for insulin pumps and basic operating supplies for medically eligible people with Type 1 diabetes who were 25 or younger.

Effective Aug. 15, the age cap will be removed, allowing people older than 25 to apply.

The Department of Health is also updating the program’s client and family contribution calculations to better account for the rising costs of living, and it will increase the number of income levels from five to seven. Adjusting the income levels and co-payments, will make the program more affordable, particularly for low- and middle-income earners.

The new client and family contributions calculations will come into effect on Oct. 1, and anyone with co-payments due before that date will not be affected. More details will be made available about these changes online by Sept. 1.

“The expansion of New Brunswick’s Insulin Pump Program will significantly and positively impact the lives of people with Type 1 diabetes in the province,” said Glenn Thibeault, executive director of government affairs, advocacy and policy for Diabetes Canada. “Managing your diabetes is a 24/7 job, with no breaks or vacations. These devices are life-changing for those who need them to manage their chronic condition and help prevent unnecessary complications and trips to the emergency room.”

Continuous Glucose Monitoring program in development

The Department of Health will soon offer coverage for continuous glucose monitoring (CGM) to people living with diabetes who require intensive insulin therapy delivered by a pump, or through multiple daily injections. This coverage will be offered to those who meet the medical eligibility criteria and the income-testing guidelines. It is expected that more than 5,000 New Brunswickers will qualify for coverage under the program.

Changing to a payer-of-last-resort model

To ensure the long-term sustainability of these programs, the Department of Health is moving to a payer-of-last-resort model. That means the provincial program will cover the costs of these benefits only after all other applicable public and private third-party payers do, such as employment benefit programs.

This model is in line with how other Atlantic provinces co-ordinate their insulin pump programs, as well as how the New Brunswick Provincial Drug Plan operates.

Under the existing first-payer model, an individual’s co-pay amount for the costs of their pumps and/or supplies is calculated based on after-tax household income and the size of their family. The person pays the pump company, and the company will bill the provincial program for the remaining amount on behalf of the individual. The person can then submit a claim to their private insurer, if they have one, for the co-pay amount.

Once the new payer-of-last-resort model comes into effect on Oct. 1, an individual’s insurance coverage, if they have any, will be factored in and only the uninsured portion will be eligible for coverage. The process will not be changing for anyone who is currently in the program and does not have employee benefits.


Media Contact:

Clarissa Andersen

Communications, Department of Health