Weak incentives limit uptake of insulin pumps

PRESSURE is mounting on the Federal Government to overhaul its failing insulin pump subsidy program, which continues to be hampered by low uptake.

Just 41 children with type 1 diabetes have received the subsidised pumps – less than a quarter of the 174 that were expected when the $5.5 million program began in November 2008.

With the maximum available subsidy capped at $2500 and pumps costing up to $8000, the technology remains unaffordable for many patients without private health insurance, critics say.

Paediatrician Dr Peter Goss of Gippsland, Victoria, is Australia’s largest single user of the scheme, having provided pumps to 11 uninsured children by relying on charity to make up the $5500 difference.

In a letter to the MJA published last week, Dr Goss said that the children’s mean HbA1c levels dropped from 9.2% to 7.6% over 10 months using the pumps.

This success made the low national uptake all the more frustrating, he told MO.

“All children, city or rural, should have access to quality insulin pump therapy,” he said. 

“The argument has been put strongly to the Government.”

Martin Silink, professor of paediatric endocrinology at the University of Sydney, said the current subsidy payments were “clearly inadequate”.

“The Government should bite the bullet and recognise that preventing diabetes complications is an important, cost-effective strategy,” he said. “They should be fully funding the pumps for those who need them.”

There had been 10 additional subsidies claimed since the issue was first raised last year (MO, 13 November 2009).

The Health Department had not responded to queries as MO went to press.

Med J Aust 2010; 192: 107-08