If you live with diabetes and have no private health care coverage, you know how quickly the cost of diabetes supplies can add up. With a global pandemic and rising US insulin costs, I wondered what the current cost of diabetes supplies was?
The cost of using multiple daily injections
Multiple daily injections would be the least costly of my insulin therapy options but it is still not free. In Canada, the cost of insulin has not really changed over the past six years. A vial of rapid insulin would still cost me approximately $35 per vial. I would also require vials of long-acting insulin which are approximately $70 per vial.
After consulting with my son, I decided that I would use at least three vials of rapid-acting insulin per month and two vials of long-acting insulin. In Canada that would mean $2940 per year for insulin.
In the US, according to prices from singlecare.com, I would have to pay $19,583.40 USD per year for the same insulin. Please note that Walmart has recently released its own ReliOn Novolog insulin. It is $72.88 for glass vial and $85.88 for FlexPen rather than the $333 used in this example.
I would also require syringes and alcohol wipes to inject the insulin. Injecting at least six times per day would equate to $985.28 per year and another $21.52 for wipes. It would be $330 for syringes and $217.80 for wipes in the US.
Canada does have provincial drug plans. Some of the plans would cover some or all of the diabetes supplies costs depending on the program that I qualified and the province that I lived in. Based on my province and my income, I would have a deductible to reach first before my supplies would be covered.
In the US, there are also some funding relief from both pharmacies, pharmaceutical companies, and government programs.
The total cost of using multiple injections without checking my blood sugar levels, checking for ketones, getting sick, or having to correct high blood sugar levels would be approximately $3946.80 without any coverage. Again, in Canada, most provinces do cover the cost of some basic diabetes supplies like insulin and syringes.
If I lived in the US, this cost would be closer to $20,131.20 per year to use multiple daily injections. Using the new ReliOn brand of insulin would drastically reduce my annual cost however. It would cost me $6403.56 to use this insulin with Lantus remaining as my long-acting insulin.
The cost of checking my blood sugar levels with a glucometer
If you are using insulin, which a person with type 1 diabetes does, it is vital for you to check your blood sugar levels on a regular basis. The Diabetes Canada Guidelines suggest a minimum of four checks per day if you are using insulin.
Being a parent of a child with diabetes, I would be craving data. I would more likely be checking my levels 8-10 times per day. It costs an average of 80 cents per test strip. This means that I would spend $2336 per year on test strips.
In the US, the same Freestyle Lite test strips are a bit more expensive. They were $1.85 per strip. Using 8 test strips per day would cost me $5401.71 per year according to the Walgreen’s website.
Again, depending on where I lived in Canada or the US, I may be able to avail of public programs that would offset some of my costs.
Most Canadian provinces cap the number of test strips that they will cover. In many cases, you can get special authorization that will override this limit, however.
The cost of checking my blood sugar levels with a Libre
The Freestyle Libre is a system that allows you to constantly check your blood glucose levels without pricking your finger. Many provinces do not cover the cost of this system. This means that you have to purchase them out of pocket. That adds more money to the cost of your diabetes supplies.
The Libre system consists of a reader (wand) and sensor. According to Diabetes Depot, the reader is $59 and the sensors are $99. The sensors last 14 days. The reader is said to be a one time purchase.
When using a Libre, there is no longer the need for as many fingersticks as when you are using a glucometer. My out-of-pocket cost for test strips would therefore go down. Fingersticks are always required for initial calibrations or whenever there is a discrepancy between what a sensor reads and how the person with diabetes feels.
Assuming that all of my sensors last the full 14 days and are not torn off or fail for any reason, or if they do fail, are replaced at no charge, I would pay $2574 for the sensors and $59 per year for the reader. In the US, I was not able to find the reader cost but sensors would total $3672 annually at a cost of $136USD per sensor. These totals does not include the cost of alcohol wipes to clean the sites for each change or any adhesive dressings used to hold the sensors in place.
None of these diabetes costs would be deferred by any public program in my province. Provinces such as Quebec and Ontario will cover the cost of these diabetes supplies however.
Learn more about the latest Libre.
The cost of checking my blood sugar levels with a Dexcom
Like the Libre, the Dexcom can be used as a stand-alone system. This means that you can use it with multiple daily injections or on any brand of insulin pump to provide a continuous stream of blood sugar data. When using the Dexcom G6, like Libre, the number of test strips required each month will be lower than a person who is not using one of these devices.
The Dexcom is made up of a receiver and sensors. According to the Canadian website, sensors are $299 for a box of three sensors. In the US, you can obtain a coupon through Good Rx and purchase three sensors for $355.11. Each sensor will last 10 days so three sensors will give you a month’s supply assuming that they do not fall off or malfunction. A receiver costs $499 in Canada and $417 in the United States.
The transmitter is $289 in Canada or $253.65 in the US. In Canada, you can buy the starter kit which includes 3 Sensors, and a Transmitter for $299. You can also set yourself up to get your Dexcom supplies by subscription. The subscription is $299 per month and includes an annual supply of sensors as well as a year of transmitters. Contact Dexcom for availability of this offer in your area.
If I am paying out of pocket, I would be looking for the lowest cost option. I would use my cell phone as a receiver and sign up for the one-year subscription for a total cost of $3588 Canadian for the year.
If I was unable to avail of a subscription in the US, the total price would be 4,931.97.
Check out your continuous glucose options below.
The cost of using an insulin pump
As a person who has been around the diabetes world for over 20 years, my personal preference would be to use an insulin pump. This is a much more expensive system to manage your diabetes.
In my province, there can be some provincial assistance for those over 25 years of age but you are subject to a means test. In the US, there are also a number of programs and insurance options for insulin pumps. For the sake of this article, however, I will assume that I would not qualify to have any insulin pump costs covered.
The insulin pump cost itself can vary. The Ypsopump is the lowest cost insulin pump on the Canadian market. They often have offers for those looking to make this their first insulin pump. This pump is not available in all countries however.
On average, in Canada, an insulin pump costs about $7200 if you have to pay out of pocket. In the United States, prices range from $3000-$10,000USD for the pump itself. These prices may vary. Some companies offer pricing plans and first-time buyer options.
A new insulin pump will last for 5 years. The cost breakdown over that time period will be $1450.00 per year in Canada or up to $2000USD.
The cost of insulin pump supplies
Insulin pump therapy requires more than just an insulin pump. I will also require infusion sets, insulin cartridges, rapid-acting insulin and alcohol wipes. I will also need a blood ketone meter and ketone strips (these are also used for those on multiple daily injections but were not included in the above total). In case of an insulin pump failure of stubborn high blood sugar, I will also need to still have some back-up syringes. The total cost of these items will be $4983.83 Canadian or $19,867.65 USD per year.
The cost of using a sensor augmented insulin pump
An insulin pump that works with a continuous glucose monitor, like the MiniMed 670G or the Tandem t:SlimX2, is called a sensor augmented insulin pump. They do not cost more to purchase but require you to use both insulin pump supplies and those that you would use for your CGM.
If I were using Medtronic’s Enlite sensors with my sensor augmented insulin pump, I could pay $65 per sensor. Each sensor will last six days. This means that I will require at least 61 sensors over a one year period. Sensors come in boxes of five so I would spend $3900 annually on sensors. I was unable to find a cost of transmitters.
*As of July 2021, Medtronic Canada has launched the CGM Access Program. A subscription will cost: $99 (1 month worth of sensors and transmitter) for a total of $1188.00 per year.
In the US, The Guardian3 sensors were $608.30 for a five-sensor box. I would require 12 boxes over the course of one year. This would equate to $7299.60USD per year.
The total cost of diabetes supplies for a person living with type 1 diabetes
No matter what method of insulin delivery you use, living with diabetes is costly. If you don’t have some form of insurance, the high costs can be crippling.
In countries like the US, the cost of something as basic as insulin can be out of reach for many even with private insurance. In many countries, high insurance deductibles leave many looking for ways to save.
Prior to the pandemic, the high cost of diabetes supplies created a surge in what is known as medical tourism. Americans were traveling to countries like Canada and Mexico to purchase their insulin over the counter at a reduced price.
Even in Canada, with the lower cost of insulin, living with diabetes comes at a high cost. Without allowing for sick days or high blood sugar corrections, using a syringe and glucometer to manage your diabetes would cost a minimum of $6282.80 per year. That is a car payment for many. Thankfully, there is some provincial coverage to help defer these costs for those who qualify.
If you want to add other technologies to your care, the costs go up as you can see in the table below.
No matter where you live, you should have access to basic diabetes care. This is not a frivolous option. It is life sustaining therapy. This therapy should not cost you the equivalent of your car payment, your rent, or all of the above. Access to diabetes devices and supplies should be a fundamental right afforded to all citizens of this planet. One day, hopefully that will be the case.