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Organizations urge UnitedHealthcare to reverse insulin pump policy for children
Three leading endocrinology and diabetes advocacy groups are calling on UnitedHealthcare to reconsider a new policy decision that extends Medtronic’s preferred position in insulin pumps to children as young as age 7 years, according to an open letter sent to the company and signed by the associations.
In February, UnitedHealthcare (UHC) announced that it was no longer covering all brands of insulin pumps for children, instead extending Medtronic’s preferred position in insulin pumps, which is already in effect for adults, to children as young as age 7 years, according to the company. In a joint letter released last month, the American Association of Clinical Endocrinologists, the American Association of Diabetes Educators and the JDRF urged the company to reverse the exclusive insulin pump agreement, noting that “any agreement that limits choice in therapies, at any age, only adds to the already overwhelming burdens of life with type 1 diabetes.”
“The decision by UHC to force people with diabetes to use only one pump supplier will make it increasingly difficult for users to access insulin pumps recommended by their health care providers if outside the preferred brand,” Kate Thomas, AADE director of advocacy, told Endocrine Today. “There are a number of different insulin pumps on the market. With each pump having its own set of advantages and disadvantages, AADE believes that people with diabetes should be provided the opportunity to work with their diabetes care team to select the insulin pump that best fits their needs and lifestyle.”
AADE had previously addressed UHC’s policy change related to insulin pumps for adults, Thomas said, and the organization “felt it critical” to get involved in this issue now that it will also impact children with diabetes.
“This is about what is best for the patient, and removing barriers to care that people with diabetes face when treating their disease,” Felice A. Caldarella, MD, FACP, CDE, FACE, treasurer of the AACE, told Endocrine Today. “It’s a difficult enough disease, dealing with the high cost of insulin and the potential complications. ... Introducing these barriers just doesn’t feel appropriate.”
Insulin pumps are not “one-size-fits-all” and have different features to meet different patient needs, according to Cynthia Rice, JDRF senior vice president of advocacy and policy.
“Different pumps have different features that let people achieve their priority clinical goals,” Rice told Endocrine Today. “Whether it is preventing low blood sugar from becoming a life-threatening emergency by sharing data with caregivers, or the way the insulin pump is attached to the body. Some have tubes, some do not. The way a pump delivers insulin can be relevant if someone is active. These are just some of the differences that can be the difference between someone achieving their glucose goals or not.”
In a statement to Endocrine Today, UHC stated that the Medtronic pump is a safe, effective option for children with type 1 diabetes,
“UnitedHealthcare has been an advocate for diabetes prevention and management for nearly a decade,” Tracey Lempner, spokeswoman for UHC, said in an email. “We are continually working to bring innovative ideas to address every aspect of this complex — and pervasive — chronic disease. For members receiving a prescription for an insulin pump for the first time, the MiniMed system from Medtronic is our preferred pump for adults and children age 7 and older, given the safety, quality and lower cost it offers. Pediatric patients who are currently using a non-Medtronic pump may remain on that pump in conjunction with the physician’s treatment plan.”
Rice said JDRF has engaged in talks with the company about the policy.
“This is not a statement against any particular company,” Caldarella said. “This is about addressing the needs of the individual patient.” – by Regina Schaffer