JDRF’s Coverage2Control Petition Calls for More Choice and Affordability from Insurers
Many of you may have heard about or even signed JDRF’s Coverage2Control petition, which asks insurers to reduce patients’ out-of-pocket costs, guarantee their insulin pump choice, and cover artificial pancreas technology. The petition has already gained over 24,000 signatures in the three weeks since launching - in fact, the JDRF has raised the goal from 10,000 to 20,000 to now 40,000 signatures. All this momentum generated for the organization’s advocacy agenda raises some questions about the access landscape: What steps can insurers take to make out-of-pocket costs more predictable? What do limited choice deals - like United Healthcare’s agreement with Medtronic to restrict choice of insulin pumps - mean for cooperation between insurers and industry? What will coverage look like for artificial pancreas technology as the industry gathers more long-term data?
The JDRF is asking insurers to make the patient cost of insulin and other diabetes management tools lower and more predictable. In doing so, the organization is urging options that could include removing diabetes tools from deductibles, lowering copayments for these tools, or allowing fixed dollar copayments instead of high-percentage coinsurance. While we haven’t seen a lot of support for diabetes from insurers, we are hopeful that the JDRF will find ways to expand coverage further.
The second piece of Coverage2Control opposes policies limiting insulin pump choice, and this demand has generated a powerful social media movement, #mypumpmychoice. Though these limited choice deals presumably result in lower prices, it is important that insurers become more aware of meaningful differences among insulin pumps. Ultimately, we would love to see lower insulin pump pricing lead to broader access and continued choice for those already on insulin pumps, and we will follow with interest as industry, insurers, and advocates negotiate this balance.
The JDRF’s additional request for full coverage of artificial pancreas technology comes on the heels of Anthem’s noncoverage decision and the indecisiveness of a number of other insurers. The decision by Anthem, which cited limitations in available studies, suggests the potential for future approval is contingent on more robust and long-term data. Aetna, Cigna, and Humana have so far taken the lead in covering the MiniMed 670G, and we hope that Coverage2Control will set the tone for increased coverage of hybrid closed loop systems as they make their way into the US market.
Type 1 and type 2 patients, friends, families, and caregivers are able to sign the Coverage2Control petition by entering their contact information, which is kept confidential. Whether or not the JDRF reaches its goal of 40,000 signatures, insurers will have been put on notice, but how will they respond? We hope for broader access across the board, which would be good patients and, by improving outcomes, benefit insurers in the long run as well.
Emma Ryan contributed to this piece.