Thank you, Madam Chair and members of the committee.
My name is Victor Lepik and I'm appearing before you as an individual who's lived with type 1 diabetes for more than 30 years. It's my hope that my appearance here today will give you a better idea of the daily challenges I face as a person living with diabetes; some solutions that have greatly enhanced my quality of life; and the need for governments across Canada to improve financial access to important diabetes drugs and services.
Having type 1 diabetes means my pancreas does not produce insulin, a hormone that controls the amount of sugar in my blood. Without insulin, I would have high blood glucose levels, which would affect my major organs, including my heart, blood vessels, nerves, eyes and kidneys, leading to serious, life-threatening complications.
While I'm very conscientious about keeping my diabetes under control, managing my blood sugar is a juggling act. Over the years, I've struggled with low blood sugar and dangerously high blood sugar. Untreated, severe low blood sugar can result in seizures, loss of consciousness and even death. In order to keep my blood sugar under control, I typically require five to seven daily injections of insulin. I also check my blood sugar levels at least 10 times a day to ensure that they're neither too high nor too low.
Late last year, I got a Dexcom continuous glucose monitor and an insulin pump to help manage my disease—decisions that turned out to be life-changing for me.
The continuous glucose monitor helps me manage my blood glucose levels. It consists of a cannula injected into my skin and a transmitter that snaps onto it. I change the cannula every week at a cost of $85. I replace the transmitter every three months at a cost of $389. B.C.'s Fair PharmaCare program does not cover either item.
The transmitter sends a cellphone signal to an app with my blood glucose information. My cellphone sounds an alarm before my blood sugar falls or rises to an unsafe, predetermined level. Unlike a finger-prick device, my continuous glucose monitor tells me whether my blood sugar is rising or falling and at what rate.
I can also share the continuous glucose monitor information electronically with my doctor and diabetes specialists. At a glance, they can easily review my blood sugar management and work with me to make improvements.
I wish I'd had a continuous glucose monitor years ago to prevent severe low blood sugar. In the past, I've often woken up in the middle of the night surrounded by paramedics, firefighters and police officers staring down at me. I have even woken up in hospital without any recollection of how I got there. This has happened to me numerous times.
The continuous glucose monitor allows me to sleep at night without the constant stress and worry that I may not wake up at all. My blood glucose levels are in better control and my physician is happy. An additional benefit is that he is no longer threatening to revoke my driver's licence.
Before the insulin pump, I needed multiple daily injections. Although I worked diligently to maintain tight insulin control to avoid complications, I still struggled with low blood sugar. I sometimes needed to eat in the middle of the night when I was not hungry. Exercise, including neighbourhood walks or playing a game of golf, was difficult, as it typically led to more insulin reactions, more eating and weight gain.
Since getting the insulin pump and continuous glucose monitor, my blood sugar levels are more consistent. I am able to exercise regularly. I rarely have to eat when I'm not hungry, and I've lost 10 pounds and counting. The pump, which typically requires replacement every five years, cost $7,000 last fall when I purchased it. At that time, B.C.'s pharmacare program funded the device only for diabetics aged 25 and under. I am 65 years old. Last July, the B.C. government announced expanded coverage for the insulin pumps by eliminating the age restriction.
While all provinces have a pump program, they are all different and many are pediatric or only up to age 25. Without a national funding program, there are still many Canadians across this country unjustly paying for a device that another province fully funds.
My endocrinologist recently recommended a faster-acting insulin called Fiasp to reduce my high blood sugar levels more quickly. The B.C. pharmacare program does not cover this insulin, and according to Diabetes Canada, no province currently lists it for coverage. It costs $38.49 for a vial that lasts me about two weeks.
While injecting insulin helps me manage my disease, it's not a cure. People with type 1 diabetes often face devastating complications, including heart attack, stroke, blindness, kidney failure, erectile dysfunction, depression, lower-limb amputations, skin conditions, hearing impairment, and an increased risk of Alzheimer's. Preventing these complications would save our health care system millions of dollars annually, yet a major challenge for people like me living with type 1 diabetes in Canada is the cost of medications, devices and supplies needed to manage the disease more efficiently.
The financial burden of managing diabetes can be a heavy one. An insulin pump every five years is $7,000. A continuous glucose monitor transmitter and cannula combined are close to $470 monthly, or more than $5,600 annually. If you include the latest, fast-acting insulin, add another $77 to the monthly cost of managing the disease, for a total of $547 each month or $6,565 annually. To help prevent complications and, most importantly, provide people with diabetes with practical solutions to improve their lives, we need a nationally funded program that is open to all, regardless of age or income.
Thank you.