The economics for pumping in SA dont' add up

I purchased a pump in South Africa from the medtronic rep in December. I started using the pump on the 6th of December - it seemed to make the reality of being a diabetic significantly more realistic!! (Not that I have been living in denial for the last 19 years?!) On the pump over the last 30 days - my control (albeit not that bad on MDIs) has significantly improved. After using up my first set of consumables I have approached the pharmacy for a repeat and they claim the medical insurance will not cover them!
Take a look at these numbers:

  1. Purchase of the Minimed 722(6th december 2010 once off) - ZAR27,500-00. => (GBP2,565.30) - Not covered by insurance
  2. Novorapid insulin vial(one month supply) - ZAR450-00 => (GBP42.00) - COVERED**
  3. Consumables(Infusion sets MT399 box of 10) - ZAR1650-00 => (GBP154.00) - Not covered by insurance
    Originally I was happy to pay for the Pump(1) above in cash as long as the medical insurance would cover the consumables. They agreed to it(or so the Medtronic rep stated). Now I am lead to believe they do not cover it on the option I am on so I have to upgrade to the premium insurance cover that is going to cost(drum roll please) -> ZAR4500-00(GBP420.00) per month from what I currently pay at ZAR3600-00(GBP335.82) per month!
    As my gran would have stated(rest her soul) - "I am not Rockerfeller I am the other fellow!"
    I am not sure what the costs are in other parts of the globe(UK or US) but I cannot see pumping as a viable solution economically speaking in the third world.
    Currently the fight goes on - my first stop is Medtronic via the Rep(lets see what she says) and then I am going to approach the insurance company(a happy diabetic is a lot less costly in the long run than an unhappy MDIer)…
    Maybe we should start a business of importing these consumables??? I am sure if we can get them for cheaper we can reduce the total cost of ownership and usage and make this more accessible to the masses!!?

I am currently in Argentina and am looking for insurance that will cover pump supplies (consumables, as you put it). I was in Uruguay for 18 months and was not able to find an insurance company or private hospital that would 1.) Accept me into their program as a Type1 diabetic and 2.) pay for any pump supplies.

I purchased my pump while still living in the USA and paying an extreme amount for insurance coverage there on an individual policy. I was able to bring almost a year’s worth of supplies with me when I moved to South America. Medtronic pump supplies are available here, in Uruguay and in many parts of the rest of the world, but in this area, they are sold for US retail prices plus local tax, which is at least 22%. No wonder there are so few people using pumps here. You’d have to be a Rockefeller!

Best of luck! I do think that if you can swing it, the pump is the very best option for long-term diabetes control. Maybe there is a lower-cost infusion set that can be used (and covered by your insurance) or you can ask for the insurance to pay a portion of the monthly supply cost on your current policy.

South Africa does have some of the best provisions in terms of medical care for the disadvantaged people - they term it chronic care. You can get your insulin direct from the government run institutions. The support of a good endochrine team is the problem however.

I am on a pretty average(better than nothing!) insurance policy but that does give me access to a chronic provider team that includes a specialist and a dietician with 3 yearly checkups. Also get the HBA1Cs thrown in. So I can't really complain.

I agree that the pump is more effective - I am back on MDIs and am already seeing how 'more careful' I have to be with what I am eating.

Thanks for the message. Good luck in South America - I am planning on a trip there for the World Cup Soccer in 2014(with my pump) :)

Hi Sansucre.

Good to find a fellow South African on this site.

I am also looking to get a pump this year and my medical aid will not cover the pump but will cover the the monthly running costs (so they say, but I have not yet officially applied, will be sure not to take the word of the rep until it is in writing). I had to go the the absolute top plan on D1$c0v3ry anyway, to prevent my insurance from running out in April - I suppose having 2 kids under 6 doesn’t help :slight_smile:

We always seem to lag the rest of the world when it comes to this type of medical technology being part and parcel of a standard medical plan. Like you alluded to, a healthy diabetic will cost the insurance company a lot less in the long run. I was interested in the a CGM to go with the pump; the costs associated with that will bankrupt you overnight.

Interestingly, I got a quote for a pump about a year ago and again last month. The price has stayed the same for the same model…despite the Rand now being 6.60 to the US$ not 8, as it was in 2009. Some things don’t add up.

How did you find the service of Medtronic and the support from the CDE pump center? One of my concerns is the insulin getting too hot in summer especially if the pump is in your pocket or under clothes; I work outside quite a but here in Pretoria and the summer temperatures are around 30 deg Cel; did you find this an issue.

Unfortunately a SAD but TRUE fact - pumping in RSA is reserved for the top 2% of the diabetic masses because of the costs and lack of insurance for everyone!!! Other less fortunate people definitely need it a lot more urgently!!!

Cheers.

Hi Quazz

It is amazing how elastic prices are upwards when the currency depreciates but very inelastic too adjust down when it appreciates. I think ‘they’(the bureaucracy) claim it is related to holding costs and old stock not turned over… Surely consumables should be turned over shortly??

I too have 3 kids under the age of 6 so I can empathise with your medical scenario. I was considering going to study medicine because in the long run I will probably be saving money!! I am currently with m*ment&m.

I got the CGM. The consumables are expensive and they only last for a couple of months. You have to change them every 6 days and inserting them can be a ^&*&^. I do believe that they are great for giving you control and also establishing the basal rate that your body will require. The great thing with CGM when I used it was that I only went out of the 5 - 8 range twice in a week.

You can follow the trends of where the sugar is heading and make adjustments(dont tell my doc) accordingly. This proved to be really benificial.

My pump center is based in Umhlanga and the docs there are really supportive and encouraging. They have been in the game for many years so know what they are doing and are on 24 hour call in case of emergency.

The medtronic rep has been really helpful - I am not sure how much comm she gets! - although she never checked what option I am on so assumed I was on the top option… I should have double checked myself.

I also get worried about the heat. I am in Durban and run a bit - I have not had any issues running with the pump attached. I am more worried about the sweat. I use the belt to strap the pump to me at night. I notice in the morning that the pump is pretty hot but the rep claims that this is not all bad.

Keep up the good fight Quazz. I am planning on going on a hike across the berg in March. I am planning to blog my sugar log and the trip on line. I will send you an update closer to the time concerning the details.

Cheers.