Manitobans are cautiously optimistic about new legislation that could mean Ottawa pays for diabetes medication along with other expenses involved in living with a disease that affects nearly a third of the people in the province.
The Pharmacare Act, enacted last week, allows the federal government to sign deals with provinces and territories to cover the costs of diabetes medications and contraception; Manitoba began offering free prescription contraceptives Oct.1.
Although the law — what the federal government calls the first phase of a national universal pharmacare program — includes a reference to “a suite of medications that reduce the risk of serious health complications and improve quality of life,” it’s not clear what that includes.
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Health Minister Uzoma Asagwara said Manitoba has “one of the most comprehensive programs for diabetes coverage in the country.”
“I have some concerns about it — is it full coverage or just for insulin?” said Winnipegger Brian MacKenzie, who has Type 1 diabetes and relies on his blood-glucose monitor to alert him when his levels are dangerously low.
MacKenzie, who is in his 70s, stays active by playing pickleball. He said insulin makes up a small fraction of the overall cost of managing the disease; the price of glucose monitors and insulin pumps can be close to $10,000.
According to Diabetes Canada’s 2023 fact sheet, 29 per cent of Manitobans were living with diabetes or pre-diabetes.
The number of Manitobans with all types of diabetes and pre-diabetes is expected to increase from 421,000 in 2023 to 504,000 in 2033, and the direct cost to the province’s health-care system — an estimated $157 million last year — is expected to increase to $203 million in 2033, Diabetes Canada said.
Approximately 80 per cent of that cost results from treating diabetes-related complications in acute-care settings.
“Diabetes is a significant driver of ill health in Manitoba and we remain quite concerned with the rates and the complications associated with it,” said Dr. Brent Roussin, Manitoba’s chief health officer.
Roussin, speaking at an unrelated news conference this week, said financial access to medication, while important, is not sufficient.
Liberal MLA Cindy Lamoureux has, for the past six years, presented a petition to the legislative assembly urging the province to work with the federal government to include prescription drugs in Canada’s universal health-care system.
“I think we should be jumping at the opportunity,” the Tyndall Park MLA said. “If you’re making them available and accessible to people, it’s going to mean way less hospitalization.”
People with diabetes are three times more likely to be hospitalized with cardiovascular disease, 12 times more likely to be hospitalized with end-stage renal disease and almost 20 times more likely to be hospitalized for a non-traumatic lower limb amputation, compared to the general population, according to Diabetes Canada.
Lamoureux’s current petition says that a national single-payer pharmacare plan would save Canadians between $4 billion and $10 billion a year, and that one out of 10 patients is not taking prescribed medication because of affordability.
People with Type 1 diabetes can pay up to six per cent of their gross annual income on medications and devices that range from $1,381 to $9,475, Diabetes Canada said. Those with Type 2 diabetes can pay up to nine per cent of their gross annual income on medications and devices that range from $554 to$6,702.
“The conversation with the federal government is an important one and ongoing,” Health Minister Uzoma Asagwara said.
“We hope to take steps that prioritize what Manitobans need and what’s in the best interest of our constituents.”
Asagwara said Manitoba has “one of the most comprehensive programs for diabetes coverage in the country.”
In 2023, Manitoba Pharmacare extended coverage for advanced glucose monitors to all adults with Type 1 and those with extreme cases of Type 2 diabetes requiring two types of insulin.
Covering all Type 2 diabetics for the glucose monitoring devices could prevent them from developing extreme cases and save the health-care system money in the long run, advocates, including MacKenzie, say.
But he’s concerned that provincial pharmacare could become entangled with federal coverage, imposing restrictions, caveats and deductibles that will make it harder for everyone to access medication and treatment that work best for them.
“I don’t want it to get mired in bureaucracy; that could really slow things down and create some more hardship for families that don’t need it…. If we want to have true universal coverage, take (Manitoba) pharmacare out of there,” he said.
“Have a doctor say, ‘This diabetic needs this, this and this,’ and provide it without a cost. Keep it simple, and for everyone.”
carol.sanders@freepress.mb.ca
Carol Sanders
Legislature reporter
Carol Sanders is a reporter at the Free Press legislature bureau. The former general assignment reporter and copy editor joined the paper in 1997. Read more about Carol.
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