May 17, 2019  Letter to Minister of Health

Hon. Pauline Frost

Box 2703

Whitehorse, Yukon

Y1A 2C6

Hon. Pauline Frost,

I listened with interest to some of the comments that were made in the legislative assembly on

Thursday, April 25, 2019. I would like to thank you for your continued work on the Type 1 Diabetes portfolio, an issue I am quite familiar with and invested in (my own child has Type 1).

I would just like to provide some clarity and concerns about some of the issues that were discussed.

Continuous Glucose Monitors

In regard to Continuous Glucose Monitors, you stated that “there is no doubt about the fact that it’s necessary and it’s essential. We will continue to do the good work and ensure that every Yukoner isprovided the support they need as we look at different circumstances.”

Honorable Frost, the Yukon T1D Support Network runs the pilot project for persons aged 19-25, and we have had to turn people away from accessing this necessary and essential device, due solely to age. We would like to provide this critical resource to all persons with Type 1 diabetes, regardless of age. Like you, we also want to ensure that every Yukoner is provided this support. Please consider immediately changing the age range of the pilot project to include all adults age 19 and over. This would be an incredible service and we would be so pleased to provide you with data as to CGM effectiveness for this population.

Insulin Coverage

In regard to insulin coverage, you stated that “we are now covering both Type 1 and Type 2 diabetes patients – 100 percent coverage for their insulin under the Yukon health care insurance plan.” It isn’t an entirely accurate statement to say that insulin is covered. I had to pay out of pocket for my own child’s insulin for a period of 18 months. When my son was prescribed Lantus insulin by his endocrinologist, we were not covered and outside of a vague letter stating that this was an ‘exception drug’, we were not provided context into why we were not covered. I was, at that time, wholly unknowledgeable about the subject of drug coverage. I now understand the Health Technology Assessment process, from manufacturer to Health Canada to the Canadian Agency for Drugs and Technology in Health and the

Common Drug Review and the Canadian Drug Expert Committee to the pan-Canadian Pharmaceutical Alliance and the Yukon Formulary Working Group. It took a tremendous amount of time and energy to research this process and only when it was understood was I able to advocate efficiently and fully informed, at last understanding what ‘exception status’ truly meant. This is a deeply flawed and incredibly complex process, resulting in drug coverage that is unequal and unclear. From direct experience, I say with conviction that insulin is not 100 percent covered.

Working with Patients

You stated that “I’m happy to say that we are working with the parents, we have looked at the constant glucose monitoring and the positive effects it’s having, and we’re working on ensuring that we have consistency in the future. That is something we are committed to. That’s the answer that I think Yukoners want to hear. They want to hear that they’re being listened to, that we’re taking into consideration the needs of every child who is out there, that we’re taking into consideration every type 1 and type 2 diabetes patient.” I am very excited to hear this, as we have written to you on a few occasions requesting a meeting. You have a huge portfolio, and I do believe that you are working hard to make things come together. I read this statement as an indication that you are willing and able to sit down with individuals who have Type 1 diabetes, their families, and their supports, and I greatly welcome this news. The hard work that you are putting into this does not go unnoticed.

In closing, I recently attended the Canadian Agency for Drugs and Technology in Health Symposium. Dr. Irfan Dhalla, Vice President, Evidence Development and Standards for Health Quality Ontario, stated in a panel discussion regarding ways to improve drug and device coverage processes that “at the end of the day, there is only one payer, and that is the patient. Whether it is through taxes, or out of pocket, it is the patient…they need to be at the table.” I sincerely trust that you, like Dr. Dhalla, will invite patients to lead the conversations about the drugs and devices that directly affect them.

Thank you for your time,

Marney Paradis

President