Good afternoon, committee members. I'm Dr. Tom Elliott, Vancouver-based diabetes specialist, UBC associate professor, and, today, chair of the BC Diabetes Foundation.
Four million Canadians live with diabetes and the dread of death or of disability from heart attack, stroke, blindness or amputation or of passing out with low sugar at meetings like this. Together, we have the means to change those four million lives. Doctors and diabetes educators have the knowledge but lack the tools.
Committee members, give us the tools, and we'll finish the job.
National pharmacare as it stands will cover most diabetes medicines, and this will be a big win, but there is one omission and two “might be” covered items that I'd like to bring to your attention today.
The Ozempic class of diabetic weight-loss drugs has been omitted. Two-thirds of the 7% of Canadians who live with type 2 diabetes are overweight. Overweight is not the cause of diabetes, but it is a contributor. Lifestyle therapy always comes first. Indeed, all overweight type 2 people living with diabetes try to lose weight and keep it off, but most fail.
Ozempic is a difference maker. My clients think of Ozempic as a miraculous therapy, and so do I, yet it has been specifically blacklisted from national pharmacare. I consider this to be driven by a fat-shaming lobby and to be discriminatory and un-Canadian. My obese clients do not choose to be obese. They deserve access to Ozempic, but fewer than half of them can afford it.
Drug costs are a major consideration. In March 2023, the canada.ca website had the following post: “[Canadian] drug prices are now the third highest among the Organisation for Economic Co-operation and Development (OECD) countries—that is about 25% above the OECD median.” Yesterday, I calculated the cost for a month's supply of Ozempic: In Canada, it's $218, while in Germany it is only $82, or almost one-third.
Now let's talk about type 1 diabetes. Three hundred thousand Canadians live with it. Onset is at ages less than 30, and there's no cure yet. It carries a colossal burden, demanding four to five shots of insulin and 10 finger pokes per day, as well as tight regulation of food and exercise.
This brings me to the two devices that might be covered by national pharmacare. These are CGMs, or continuous glucose meters, $8 a day, and an insulin pump, $10 a day. When these two are combined with a smart phone app, they provide for automated insulin delivery, or AID. Both of these devices need pharmacare inclusion. AID is a technological cure for type 1 diabetes. Put simply, AID keeps the sugar steady, just like cruise control keeps the speed steady while driving a car.
I'd now like to invite Ramya Hosak, who lives with type 1 diabetes and sits on the foundation's board with me, to relate her first-hand experience.
Ramya, over to you.