As someone who was able to manage my type 2 diabetes for 16 years without the use of insulin or medications, I came to rely quite heavily on regular bg testing with my strips. Morning fasting would tell me how I was doing in general, while premeal testing indicated how many grams of carbs I could indulge in and post meal testing would show how effective my exercise was. For years our provincial medical services plan provided me with all the strips I needed, usually about 5 a day or around 1500 in the course of a year. Now I found myself being cut off in early spring, they are saying they now have a limit of 200 strips a year for those on common medications as well as diet and exercise, while diabetics injecting insulin are allowed 3000 strips a year. I have no gripe with type 1s or 2s injecting insulin getting the large quota, I do however question the motives of those limiting test strips to the diet, exercise or medications only category to a paltry 200 a year. The cost of strips after that is about a dollar each which makes a sizeable dent in the budget of pensioners like me.
So I would like the opinion of other members of this valued website and forum, is there a fair reason to limit test strips to 200 a year to those not on insulin, besides the desire to save money and possibly cull favours with parts of the pharmaceutical industry?
The theory they use is that the vast majority of patients either do not test more than once a day - at best - or do not make changes based on the results of those tests. As a result, added test strips incur unnecessary expense, plus even create stress for the patient (for not following instructions) - so, the easiest way out if to limit strips to those that “don’t really need them” (supposedly).
That said, your approach (which was what I did when I was on orals + exercise), makes a LOT of sense and is clearly better for you and your overall health. Perhaps your doctor can request an exception in your case, citing your logs and results as evidence of medical necessity? I’m not sure how things work under your provincial services.
My insurance limits me to 200 strips/month (I am using insulin); however, I switched to using the One Drop meter and get unlimited strips for <$40/month. When I was on orals - and in fact, also now, I was testing 7-8 times a day. I don’t think that’s available in Canada yet, but it’s been an option that’s worked well for me, so far. Are there no cheaper options in Canada? Here, Wal-mart sells their Relion Prime meter and strips for $0.18 each - can add up, certainly less than $1/strip.
I believe that before this decision was made, the province did some research and found that “most” people used strips below the limit at which they cut off, and also that research studies show “no benefit” to diabetes control of having people with Type 2 test often. Of course, we all know that if one actually uses the data collected from testing to modify their diet, it can be very useful, but most people don’t do that.
I know that for people using insulin, at least, you’re able to have your endocrinologist write to the province and request a higher limit, and doing so isn’t usually hard nor questioned. If I wasn’t using a Dexcom, 3000 strips a year (which is equivilent to about eight strips a day) wouldn’t be enough; as it is even using the Dexcom I test six to seven times a day. Have you tried having your endocrinologist (if you see one?) write to request more strips per year?
Less than one strip a day seems useless to me, but I can imagine that “most” people who aren’t using insulin likely do not test multiple times daily and use the data that testing provides. Most people with Type 2 I know do not test daily but rather rely on their A1c result, which admittedly is often not bad. I like to think that the province treats those not using insulin the same way as those using insulin, using data about how many strips people actually use throughout the province and results of research studies to make their decision, but also allowing for those who need more than the standard level of strips to obtain it fairly easily with a letter.
Hopefully a study that shows that providing people with diabetes unlimited strips and teaching them how to use the resulting data improves control will come out soon…
Unless you are seeing huge variances in the numbers that sounds like a bit much.
However on eBay or Amazon you can get them at about .20 / strip.
From what I can tell, we don’t have Relion here or similar cheaper brands here.
Bayer Contour Next meters are pretty highly rated and a quick search on Amazon.ca show you can order 300 strips for $169 (Canadian) which is $124 USD. Each strip would then come in at 56 cents, Canadian, or 41 cents USD. Not quite as inexpensive as we get them in the US but better than $1 per strip or going with a less accurate meter. Sorry to hear your supply is being throttled. I would hope there would be room to incease the amount when appropriate use could be documented.
The Dario meter also has strips that are a bit less - though still higher than we pay in the US. See http://intro.mydario.ca
I like that meter, but since I don’t carry an iPhone generally, I use it as a backup meter or as a meter for hiking or biking - small and very convenient.
(those Amazon Bayer strips look less expensive, though…)
If that is the rationale for the policy (and it may well be), it makes absolutely, utterly no logical sense. If the patient doesn’t use up all their allocated strips, they won’t go back for more as frequently, so any imagined cost saving is a complete illusion. The cost of strips not acquired or dispensed is zero.
P.S. Diabetes Hands Foundation, the parent organization of TuDiabetes, is partnering with Livongo to make THIS OFFER to TuDiabetes members. I’m thinking seriously of taking them up on it. “Unlimited strips” is pretty tempting. The catch, unfortunately, is that I don’t know whether the offer is valid in Canada or not.
unfortunately it’s limited to PWD in the US
I’m talking about the US here, a college town, but I see signs posted on telephone polls and by the side of the road that will say, “Cash for diabetic test strips - call…”. Now, I assume they are talking unused strips here. There must be a black market for this stuff. How sad on so many levels.
I read this as “commit insurance fraud and get money”. As you say - how sad.
We often complain about insurance companies restricting the number of test strips, but the flip side is the insurance companies need a way to protect against this kind of fraud as someone may claim to test 8 times a day, but really only test 4 times a day and resell 4 strips a day for profit.
With that said, I think the limit in the original post is a bit on the silly side.
So strips cost more in Canada than the U.S?
Is eBay different there?
I’m not sure. In the U.S., 50 Freestyle Lite strips cost around $65 or so, straight up retail. How does that compare?
They’re all about the same price here regardless of brand - $78 CDN for 100 strips.
I think name-brand strips are theoretically cheaper (and about half the price if you were to buy them in American dollars) but we don’t really have a generic market. It’s great if you have private/employer prescription drug insurance, as (at least in my experience) you can choose any meter you want, since the strips all cost the same. However, if you don’t have insurance or live in a province with a drug plan, it’s expensive. The Canadian Diabetes Association has a program that will pay about $900 or so for test strips if you don’t have insurance, but I think it’s only in Ontario unfortunately.
We do have our own eBay here - www.ebay.ca.
The main problem right now is that the Canadian dollar has been devalued to about two thirds of what is what worth around five years ago and since all strips are imported with prices set in US dollars we are paying blood prices for what used to be cheap commodities. As for why the Canadian dollar is so low, I am not an economist but I assume it is because we rely heavily on royalties from oil and gas, particularly dirty oil (bitumen) from the Alberta oil sands. After the Saudis decided to crash the oil prices a few years back, the cost of extracting the Canadian oil has exceeded what it was worth on the world market. Hence, more expensive testing strips…
I don’t know regulations in Canada, but in US, insurance sometimes makes exceptions when shown the need for more of something. Ask your doctor to write and explain that you’re using more strips to get good control, and without the strips you’ll probably need drugs and will possibly get expensive complications. In the long run it will be cheaper for the province to provide you with more strips.
I’m still kind of new to the whole diabetes thing, diagnosed last August, after a trip to emergency and a BG level of 67. That’s 67 mmol/L. Apparently that’s kind of high, like by over 10 times normal. They later told me I should have been comatose, but I’m a pretty big guy with a high tolerance for, well, everything.
I am supposedly type 2, but I have to take pills, as well as a long acting insulin and a rapid insulin at every meal or snack. Not sure how that really differs from type 1? As such, I test about 10 times a day roughly. On a per day basis, my meds work out to roughly 16.50 Canadian. I live in Ontario. I was unemployed when diagnosed, and was told that Diabetes assn. would cover cost of strips and lancets, and Trillium foundation would pay for meds. I applied to both and was accepted.
This is where it gets crazy. I submitted my first invoice for test strips to CDA after I had used up the box given to me at the hospital, and they reimbursed me for it. I was told Trillium had a deductible, but cost of insulin would eat that up in no time, so would be covered soon. Well, I turns out, Trillium deductible is based on previous year’s income, so ultimately, they say my deductible is $3200. On top of that, CDA now says my strips are covered by Trillium, and will no longer cover them. Long story short, I have to pay everything out of pocket, although I have had 0 income since last September.
I’m a carb counter, and have worked VERY diligently to get my A1C down to 5.7. The only way that was even remotely possible was to test before and after every meal and snack, and at bedtime, and first thing in the morning. Now that I can seldom afford to buy new strips, I test as often as I can, but I can always tell if I’m off by too much when not testing. I feel completely different. I guess what I’m saying, is, although I’m sure different people react differently to varying BG levels, I need to test at least 10 times a day, and when I don’t, I feel terrible, simply because I don’t have a base to start with before taking meal time insulin, or to know if I should have a snack before bed etc. or before going out to cut the grass. The fact that the Government feels it knows each individuals case and can dictate how many strips will be provided, IF AT ALL, is just wrong. I can get condoms by the handful, smoking cessation medications by the pail full, but I can’t get a package of test strips that I need to maintain some semblance of a normal quality of life. Typical.
That’s not right. I hope that you can figure out some way to test as often as you’d like. I’ve always tested more frequently than the average person for the same reasons you do – we just want to know where our blood glucose level is so we can respond appropriately. I think many doctors face the opposite situation with many patients as the patients would rather test as few times per day as possible.
While both type I (T1D) and type II diabetics (T2D) can take insulin, they differ in some important ways. Type I diabetes is an autoimmune system malfunction where the body’s immune system destroys the cells in the pancreas responsible for insulin secretion. The presence of autoimmune antibodies in the blood of people with T1D is a prime indicator for diagnosis.
T2D, however, often shows high levels on insulin production and presence in the blood combined with high blood sugar. The body often becomes insulin resistant and as blood sugar levels rise to unhealthy levels. A T2D diagnosis is less precise as T1D and people with T2D vary in their presentation. T2D is often, not always, associated with metabolic syndrome. According to the Mayo Clinic, “metabolic syndrome is a cluster of conditions — increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels — that occur together, increasing your risk of heart disease, stroke and diabetes.”
Understand that association is not necessarily causation. As time goes by, science has been revealing a genetic component to T2D susceptibility. Some studies suggest that T2D causes both weight gain and T2D symptoms that lead to diagnosis. Many of the uniformed public believe that weight gain causes T2D, an unfortunate and incorrect conclusion.
No type of diabetes is anyone’s fault!