Advocates say the
nation's largest health insurer is limiting insulin pump choices for
children
By Christopher Snowbeck Star Tribune
FEBRUARY 4, 2019 — 3:40PM
An advocacy group for patients with Type 1 diabetes is
blasting a new UnitedHealthcare policy that expands an existing agreement with
Medtronic and makes the manufacturer's medical devices the
"preferred" insulin pumps for children with the autoimmune condition.
On Friday, Minnetonka-based UnitedHealthcare published a
bulletin to health care providers saying the Medtronic product would become the
preferred insulin pump for children age 7 and older who are receiving a
prescription for an insulin pump for the first time.
The health insurer cited the safety, quality and cost of
the Medtronic device in its decision, but the advocacy group JDRF calls the new
policy "an unacceptable step backward" because UnitedHealthcare is no
longer covering all brands of insulin pumps for children.
"We don't think an insurance company should decide
what kind of insulin pump a 7-year-old gets to use," said Cynthia Rice,
senior vice president for advocacy and policy at JDRF. "We strongly oppose
this new policy."
Patients with Type 1 diabetes also pushed back against
an earlier policy established in 2016 by
UnitedHealthcare, which made Medtronic insulin pumps the preferred devices for
adults, too.
With the new policy, children who currently use a
different brand of insulin pump can continue with that device, the insurer
says. Access to non-Medtronic devices is still available if patients go through
a clinical review process, UnitedHealthcare officials say. If approved, the
alternate device would be covered with in-network benefit levels through
participating providers.
"Safety and helping individuals with diabetes avoid
dangerous highs and lows in their sugar levels were the key factors in our decision,"
said Stephen Shivinsky, a UnitedHealthcare spokesman, via e-mail.
The new policy extends a novel collaboration between two
of Minnesota's biggest names in health care, since Medtronic's operations
headquarters are based in Fridley. While about 29 million Americans suffer from
diabetes, in which blood sugar levels are above normal, the policy is critical
to the much smaller group of patients with Type 1 diabetes, an autoimmune
disease in which the pancreas stops producing insulin.
Based in New York, JDRF advocates for patients and funds
research into Type 1 diabetes. The group said in a statement Monday that
insulin pumps are sophisticated medical devices, where different devices work
better for different patients. So, patients and their doctors should maintain
freedom of choice with pumps, the group says.
"We urge UnitedHealthcare to reconsider this
decision," JDRF said in a statement.
UnitedHealthcare says nearly nine in 10 of all its
health plan members who use insulin pumps currently use a Medtronic device.
While JDRF says it's concerned policies like that from UnitedHealthcare could
stifle innovation, the insurer says it will review evidence that supports
providing subscribers with access to new and advanced therapies to manage
diabetes.
Twitter: @chrissnowbeck
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