Prevalence and cost data for the Northwest Territories are unavailable through the Diabetes: Canada at the ... Best Prac
At the Tipping Point:
Diabetes in the Northwest Territories Key Statistics – Prevalence and Costs
1
• Prevalence and cost data for the Northwest Territories are unavailable through the Diabetes: Canada at the Tipping Point - Charting a New Path report due to its small population. • NDSS identifies a prevalence rate for diagnosed diabetes of 5.2%.2 • Estimated annual out-of-pocket cost for both type 1 and type 2 diabetes: $0 (0% of individual income).
Policy Framework Provincial strategy • Chronic disease framework
Best Practices/Major Developments since Diabetes Report 2005 • Most extensive coverage for diabetes medications in Canada • Extensive coverage for diabetes devices and supplies
Factors Influencing Diabetes in The Northwest Territories • The Northwest Territories has the second highest proportion of Aboriginal populations in Canada according to the 2006 Canadian census – 50.3%.3 Diabetes prevalence rates among Aboriginal populations are at least 3 times higher than the general population. • Aboriginal populations also face higher risk for prediabetes, overweight and obesity, and developing type 2 diabetes at a younger age. • Aboriginal women are particularly vulnerable to diabetes – they have 4 times the rate of nonAboriginal women. They are also at higher risk for gestational diabetes.
Best Practices/Developments since 2005 • NT provides the most extensive coverage for diabetes medications (10 medications out of 23 are listed) under the Non-Insured Health Benefit (NIHB) program. It has raised the eligible income levels for benefits under its Monitoring for Health Program (2006). • NT provides coverage for dilated eye exams and mental health counseling or depression screening. • NT offers diabetes education programs targeted at Aboriginal populations. • Coordinated care for diabetes is integrated within NT’s chronic disease framework which has stated goals or objectives for managing complications or comorbidities. 1 Estimated annual out-of-pocket costs for type 1 and type 2 diabetes are calculated based on composite case studies as noted in Diabetes: Canada at the Tipping Point –
Charting a New Path. As such, these situations apply to many people with diabetes in the Northwest Territories, but not all. 2 Report from the National Diabetes Surveillance System: Diabetes in Canada, 2009 3
Statistics Canada. Aboriginal Peoples in Canada in 2006: Inuit, Metis and First Nations, 2006 Census. Ottawa, Statistics Canada, 2008 (Cat. No. 97-558-XIE).
At the Tipping Point: Diabetes in the Northwest Territories
Coverage for Medications, Devices and Supplies Two composite case studies were compiled for Diabetes: Canada at the Tipping Point - Charting a New Path to show the challenges faced by Canadians living with diabetes. Access to medications, supplies and devices still depends upon where they live in Canada. Below is a snapshot of coverage in the Northwest Territories. Listed
Restricted
Not Listed
10
2
11
Vascular Protection
3
1
0
Dyslipidemia
6
0
0
Blood Glucose strips
ü
Blood Glucose strips
ü
Hypertension
9
0
0
Ketone strips
ü
Ketone strips
ü
Acute Coronary Syndromes
3
0
1
Lancets
ü
Lancets
ü
Diabetes in People with Heart Failure
4
0
0
Meters
ü
Meters
ü
Chronic Kidney Disease in Diabetes
2
0
0
Syringes/Pen needles
ü
Oral medications
ü
Neuropathy
1
1
1
Pumps
Special approval
Obesity in Diabetes
0
0
1
Pump supplies
Special approval
Psychological Aspects of Diabetes
2
0
0
Insulin
Smoking Cessation
0
0
3
COVERAGE FOR MEDICATIONS Medications for Diabetes (23)
Coverage for Supplies and Devices4 Janet, 22, Type 1 Diabetes Composite Case Study: 100% coverage for all diabetes drugs and supplies.
Medications for Complications (38)
Peter, 52, Type 2 Diabetes Composite Case Study: 100% coverage for all diabetes drugs and supplies.
ü
In Their Own Words:
People Living with Diabetes in the Northwest Territories Jerry Loomis 68 Norman Wells
Jerry recalls the anger he felt when he learned of his type 2 diabetes in 2000. Nonetheless, he took seriously his doctor’s warning that he could suffer a heart attack or stroke, and took control of his situation. “I went on a diet, exercised and lost 116 pounds in 16 months. I’m careful to eat properly, keep my weight in check and stick to my management program.” Jerry’s condition is well managed, and he still does not require daily medications. Jerry advocates improving the availability and affordability of nutritious food in the north and worries about the federal government’s decision to end its food mail program that subsidized the cost of mailing food to northern communities. Instead, the subsidy will be given directly to food retailers. “This will work against consumers and especially people with diabetes, as we do not expect retailers to include the full subsidy in pricing. Food will be more expensive, and people with diabetes who can’t afford healthy foods will be at risk.” Jerry and his wife Monica are considering moving to Edmonton, where he will have better access to medical professionals. He remains active as a diabetes advocate in the north.
4 Based on composite case studies as noted in Diabetes: Canada at the Tipping Point - Charting a New Path; see note 1.
2
