The November 2008 announcement by the BC Premier and the BC Minister of Health Services that the province will fund insulin pumps—as well as related supplies—for children with type 1 diabetes aged 18 and under will allow greater access to this medical device for those patients who meet the medical criteria for pump therapy. Previously, insulin pump therapy has not been affordable for all families of children with type 1 diabetes. The new program will fund pumps (and associated infusion sets and reservoirs) through the Ministry of Health Services’ Special Authority process; the actual cost of the pump will therefore be affected by your Fair PharmaCare deductible, co-pay and family maximum, as well as by any private insurance you may have. For this reason, it is important to ensure that your family has signed up for Fair PharmaCare, to ensure you are maximizing the benefit you receive.
A number of years ago, BC Children’s Hospital established a set of eligibility criteria for children for pump therapy, including the demonstration of an understanding of insulin action and insulin dose adjustment, the ability to do advanced carbohydrate counting, and a realistic understanding of the pros and cons of pumping. As well, children need to be testing their blood sugars a minimum of 4 times a day (including lunchtime and some overnight checks). These criteria are spelled out in our handout Are You Ready to Pump?.
The decision by the BC Ministry of Health Services to fund pumps will not alter our approach to deciding which children are eligible for a pump. Indeed, the Patient / Family Agreement for an Insulin Pump, which all parents and teens are required to sign prior to the government funding of the pump, is based on our Are You Ready to Pump? handout.
As before, the decision to begin on a pump must be made individually with your Endocrinologist and the diabetes healthcare team at BC Children’s, as that is the only way he or she will agree to sign the necessary paperwork to have the pump funded by Fair PharmaCare and/or by private insurers. Only then will an appointment be made to come in and start on the pump. If your child’s Pediatrician signs the form for you, then he or she will be responsible for organizing and initiating the pump training and insulin dosing.
Please note that we already have a waiting list to start pump therapy at BC Children’s Hospital, due to limited nursing resources (all pump starts and most follow-up are done outside of clinic hours). The new pump funding program does not at present provide for more pump training time. This waiting list will likely grow in the short term with the new funding decision. But this time does give families an opportunity to complete the extensive “homework” required to begin on a pump (which includes reading a portion of a manual on pumping, instituting carbohydrate counting at home, completing an online virtual pump course, and watching the video which comes with the new pump).
Families with extended benefits will need to complete the paperwork for both the Ministry of Health Services' Special Authority process, as well as for your insurer. The pump company representatives should be able to assist you with the paperwork for your insurer.
Please know that we will continue to strive to work with each family to improve the overall level of diabetes care for their child, which in many cases may involve pump therapy. We ask for your patience while we all adjust to the new broadened financial support for pumps from the government.
For more information about the process of obtaining a pump, please see our handout Insulin Pump Therapy.
The Pediatric Endocrinologists and Diabetes Education Staff
BCCH Endocrinology & Diabetes Unit
Online Resources from the BC Ministry of Health Services Website: