Diabetes Access Matters - Draft
As a community, we are committed to enhancing the lives of all individuals living with diabetes, which necessitates easy access to therapies and technologies. Making the healthy choice the easy choice is essential, and payers and governments can play an enabling role in that quest by following these principles:
1. There is no one-size-fits-all solution for diabetes. Patients span all ages, all income levels, and all ethnicities.
- How can payers accommodate and hear from all patients, particularly those struggling the most to manage their diabetes?
2. People with diabetes want to have a productive dialogue with insurance companies and governments about access. Sharing and listening to diverse perspectives will benefit patients, providers, payers, and governments, increasing the possibility of favorable outcomes and a higher quality of life.
- How can the diabetes community and payers begin an open dialogue? What elements are important to sustain and strengthen an open dialogue?
3. Direct patient feedback seems to be missing when major payer decisions are made. Hearing patient stories can be quite instructive. Diabetes is 99% self-managed, and for people on insulin, this means dosing a potentially deadly drug every day. Type 2 patients who take some of the most commonly prescribed drugs can also be at high risk of hypoglycemia, as are all people with diabetes on mealtime or long acting insulin. We believe payers will learn from hearing directly from patients before making major coverage decisions.
- How can payers reach out to the diabetes community before making major coverage decisions?
- As an aside, direct patient feedback seems to be missing in minor payer decisions too – leading us to wonder if there is an appetite at all to hear from patients.
4. Low-cost, low-hassle access to a wide variety of diabetes drugs and technologies can save lives and make healthcare providers more efficient and more successful. Too often, patients and providers must jump through ridiculous hoops to get access to therapies – or worse, they simply give up.
- How can payers reduce the hurdles to obtaining diabetes drugs and technologies?
5. Open competition between diabetes companies may prompt faster innovation and lower prices. Patients are concerned about single-source contracts that limit choice to one therapeutic option. These therapies and technologies are complex, and shifting patients to one specific product can result in weaker diabetes management.
- Can payers promote a healthy commercial environment where multiple companies can supply products to patients, compete fairly, and succeed?
- Are payers concerned about any fields (e.g., insulin pumps) where there is a risk of small companies (e.g., Asante) going out of business and being left with one manufacturer who could then increase prices?
6. There is an opportunity for payers to support the patient-doctor relationship by understanding the environment in which physicians and nurses are working today.
- How well do payers understand what providers actually do – including what happens when patients go home?
- How well do payers understand patient-doctor relationships? How do payers think they could help make these more productive?
7. Patients could help prevent system waste and reduce system costs.
- Have payers spoken to patients about the matter?
8. Patients would appreciate if payers could think beyond A1c as the only outcome of importance in diabetes. Hypoglycemia, time-in-range, daily burdens, stress, worry, and guilt are not reflected in A1c – but they can be very important to our success.
- How can payers expand outcomes beyond A1c to include other measures that matter?
This open letter was written by the diaTribe team following a discussion involving multiple members of the diabetes advocacy community. As it is still a draft, we welcome your feedback.