To the Editor: In Australia, patients with type 1 diabetes and private health insurance are eligible for rebates on the purchase price of insulin pumps if deemed necessary for treatment. In contrast, hospital-funded or donated pumps are often used by non-insured patients. Hospitals may provide pumps to certain patients for various reasons — for example, to pregnant women (to improve their glycaemic control), to patients who want to try the pump to determine their preference or their ability to use it, or to patients waiting for private health insurance cover to be activated. Patient selection is important, as insulin pumps are cost-effective only if they reduce levels of glycated haemoglobin (HbA1c) and the frequency of hypoglycaemia1 — although quality of life may also be an important benefit.
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- 1 Department of Endocrinology and Diabetes, Fremantle Hospital, Fremantle, WA.
- 2 Department of Medicine, Fremantle Hospital, Fremantle, WA.
- 3 School of Medicine and Pharmacology, University of Western Australia, Fremantle, WA.
- 1. Cohen N, Minshall ME, Sharon-Nash L, et al. Continuous subcutaneous insulin infusion versus multiple daily injections of insulin: economic comparison in adult and adolescent type 1 diabetes mellitus in Australia. Pharmacoeconomics 2007; 25: 881-897.