Yesterday the diabetes online community (DOC) became abuzz with the news that effective July 1st, United Healthcare (UHC) was partnering with Medtronic as their ONLY in-network insulin pump brand. While people who are using other pumps still on warranty would be covered until that warranty expired, and the change does not apply to pediatric patients, this is a significant restriction of choice. Many people wrote eloquently about numerous implication of this collusion. Here is a comprehensive coverage of the news and reaction from DOC.
This new change does not affect us directly. We are not using Medtronic pump and our insurance is not through United Healthcare. But we are affected nevertheless and I’m about to unleash my emotions here. I.AM.ANGRY. And also
a little scared.
I am angry that UHC and Medtronic colluded to restrict patient choices in the name of profit. They say it’s for patients’ own good but come on, really? We are not stupid. Whenever did restricting choice and access improve outcomes? Access and choice are not luxury, they are necessity. Diabetes is damn difficult to manage and no insulin pump is created equal. People have good reasons to pick one pump over another. It may be due to integration of Continuous Blood Glucose Monitoring (CGM) with the pump, or ease of using it, or amount of insulin it can store, or possibility smaller incremental delivery of insulin, or pump being waterproof. For example, we chose OmniPod partially because our daughter is very active and we did not want to deal with tubing and disconnect for physical activities. This proved to be a very wise decision. Turns out that discontinuing background insulin (which is what happens when one needs to disconnect form the pump) has a drastic effect on increasing V’s BG.
I am angry that the two companies made the decision in the name of patient outcomes without consulting with patients and doctors. Of course I don’t buy that line of “we are doing it for your own good.” And yet, if they claim to be listening to patients, how is their decision reflective of what patients need?
I am angry on behalf of all people who will soon be directly affected by this decision. People who have to give up the pumps they use and love for the one that may not be right for them. People who may have worse outcomes because of this change. People who will have to endure yet another fight with their insurance company to meet their needs.
I am angry specifically at Medtronic for entering into this deal with UHC. I would expect this from an insurance company. But from a company that is supposedly working to help diabetics improve outcomes and quality of life? It feels like a low blow and a serious breach of trust.
I am angry of how this decision makes an already difficult and frustrating disease even more difficult and frustrating to manage.
I am scared of how this sets up an ugly precedent. Which other insurance companies will follow suit? Which other pump manufacturers will jump on the bandwagon? Are we next?
I am scared of what this will mean a few years down the road in terms of innovation. Will other companies be driven out of business? Will this impede collaboration between different companies in their joint effort to bring better tools and technology?
I am scared of what this will mean a few years down the road in terms of Artificial Pancreas technology. Will our daughter be able to choose based on her needs? Will there even be more than one choice?
I am angry and scared. And I am energized. I stand with all those who are immediately affected by UHC/Medtronic collusion and with everyone else in the diabetes community who believe that a major line was crossed. We will fight this and we won’t go down quietly.