Red Alert

D-Day for diabetics

Posted by on December 1st, 2012

Today the government, through Pharmac, ceases to subsidise the Roche Accu-Check blood glucose meters used by 80% of NZ’s 200,000 diabetics. About 20% of diabetics use the Abbott meters and 0.5% use the Care-Sens meters. But Pharmac has chosen to give the contract for subsidised meters to the people who import the Care-Sens model, Pharmaco. All of them. One supplier. Dangerous and unnecessary. But apparently it will save $10 million!

Pharmaco is running training sessions for pharmacists, doctors and other health professionals on how to use these meters so they can teach their patients and customers how to use the new meters. They are calling them “Meet your Meter”. I am so tempted to call them “Meet your Maker” seminars but that would be too inflammatory.

Diabetics depend on these meters. They are used to identify blood glucose levels so that Type 1 diabetics know how much insulin they need to inject right now and Type 2 diabetics know how many jelly beans to consume right now. Pharmaco tendered for the contract on the basis of a meter which was inferior to the one used by most diabetics, but after an outcry from the diabetics themselves, they upgraded the meter to a comparable one.

Changing over medical devices is a risky business. Changing to a sole supplier is crazy.  They will have no competition to upgrade their product over time or provide good after sales service. Their predecessors did both of those things. Pharmaco is now working in a hostile environment. They had better be careful to get this right. Lives depend on it.


25 Responses to “D-Day for diabetics”

  1. Gail says:

    Thanks Maryan for being such a support for us, right from the onset…you’ll get my vote next time round!

    We people with Type 1 and those who are Type 2 on insulin are extremely frightened and concerned as to how we will be able to trust these new meters.
    I was diagnosed with Type 1 55yrs ago and am now hypo-unaware. I depend on my Optium Xceed meter as the most reliable tool to let me know when I’m low. I trialled the Caresens N in June (CareSens N Pop wasn’t available at the time) and found it sadly lacking. I have tried to have ‘faith’ but after a few missed hypos, I am no longer trusting the new meter. Do we have to wait for some poor soul to die from an undetected hypo before PHARMAC see sense and revisit this inane decision? …I won’t hold my breath.

  2. David King says:

    My medical professionals have told me to wait until they receive their own education from Pharmaco before they will even consider sorting out my replacement meter.

    The other aspect of having a sole supplier is the scheduled change of measurement units used. Currently meters use mg/dl. Blood Test results are moving to mmol/l and I guess meters will also be required to move to mmol/l. Not likely in a sole supplier environment though.

  3. Psycho Milt says:

    Oh, bollocks. I’ve used half a dozen different meters since getting type 1 diabetes, none of them have required training to use, and every one of them has involved nothing more medically complex than putting a drop of blood on a test strip and seeing what number the machine comes up with. (Hell, 25 years ago you didn’t even get a number, you got to compare colours and take a guess.) Is anyone claiming that Pharmac’s funding a machine that dishes up the wrong number? Becauase, if no-one’s claiming that, how about they get a grip on themselves and maybe thank Pharmac for finding a way to hand us those numbers at a lower cost to the taxpayer?

  4. Maryan Street says:

    @Psycho Milt – how lovely for you. I am very pleased your experience has been and will be so easy. I just say, get out more. Life isn’t the same for others.

  5. Psycho Milt says:

    In other words, no, nobody’s claiming Pharmac’s meter provides incorrect numbers. So, what exactly is the problem then? Is this one of those “Give me convenience or give me death” things?

  6. Blarney Stone says:

    Maryan you are proving again why you are doing such a terrible job as health spokesman. You just can’t see the wood for the trees. As you know, the decision to purchase these metres is a Pharmac decision made independent of Ministers. Who are you to second-guess the decisions made by medical professionals? You are just playing low politics and you are exploiting the fears of vulnerable people over this. Shame on you.

    Maryan can you also disclose whether you have had any meetings with Roche or their representatives in the last year?

  7. Zoe Kay says:

    @ Blarney Stone: Those so called medical professionals allowed this decision to go ahead, without testing these new meters in the field and without due regard to their accuracy out of a laboratory situation. No testing was done involving children to my knowledge.

    @Psycho Milt – it’s wonderful that you have survived 25 years, especially starting with such ways of having to test without today’s superior technology. As for accuracy of these new meters, my daughter who has Type 1, has so far had 3 hypos where the new meter said she wasn’t having one, while her Accuchek meter(s) showed she was. If she had to rely on the new one, she could have treated her hypo incorrectly and plummeted down as a result as she isn’t always hypo aware. She was ill recently and had ketones. The accuchek meter(s) read 18 and the CareSens NPop read 25. You of all people must know how that would influence how much insulin had to be injected and what the consequences would be if too much was administered.

    Thank you Maryan so much for supporting those with Type 1 diabetes, whose choice has been taken away and are facing the prospect of what appear to be inaccurate meters, in our personal experience.

  8. Type1 mum says:

    Thank you Maryan, you have been a great source of support for us. Life is hard enough living with this disease to have to fight to keep the technology that is accurate and works best for my sons individual needs.

    Blarney Stone, you will find that the majority of health professionals were against this change of meters. Over 3000 submissions AGAINST this change were received, from diabetics, health professionals, diabetes groups. This change is NOT welcome and NOT supported.

    Keep up the good work Maryan, we need more politicians like you that actually care about the most vulnerable in this country.

  9. Vanessa says:

    Many of those who are now using a CareSens glucometer ARE indeed experiencing large discrepancies in their results. Some making test comparisons with the same drop of blood at the same time are getting numbers from the CareSens that are vastly different from 2 or 3 other meters. As a type 1 we rely on the accurate measurement of our blood glucose so we can decide how and when to treat hypoglycemia (low sugars) and how much insulin to inject when our sugars are above our goal. If we are not 100% confident of our blood glucose levels we can not make the correct decision regarding our subsequent actions. The Government may have convinced the general public of the benefits of the $10 million saving but how many of us in the Diabetic community will end up in hospital as a direct result of making a wrong correction based on inaccurate BG readings? How much will that drain from the health dollar long term? What happens if the sole supplier, for whatever reason, is unable to deliver us test strips? This decision was a very short sighted plan that will no doubt end up costing the ambulance at the bottom of the cliff a lot more than $10 million. What value is put on my life and the lives of every Diabetic effected by this ill informed, medically flawed, blind stupidity?

  10. Elizabeth says:

    I will direct my comments to Blarney Stone and Psycho Milt as the others have ably written regarding the discrepancies in readings by testing the Caresens meters and strips alongside their existing meters.
    Blarney stone and Psycho Milt either one or both of you must be a National MP or work for Pharmac, otherwise you would not be so outspoken in your comments to Maryan, who is the ONLY MP to take up the challenge and help people with diabetes.
    To Blarney Stone, you say Pharmac make decisions independently of Ministers, I suggest you read Pharmac’s website, Pharmac was set up by the Ministry of Health and therefore are answerable to them. Unfortunately at present we have a Minister of Health who cares little for the diabetics in this country and would prefer to bury his head in the sand. he spouts numbers in his replies to questions in the House all the time skirting around answering any question directly.

  11. Erica says:

    I think so far Maryan is the most educated minister out there when it comes to diabetes, as she has taken the time to LISTEN to those who have it, Pharmac didn’t listen when almost everyone who made a submission was against this move and they still enacted it. :( I’m just worried now whos going to pay for that ignorance and failure to hear those who know best ie the ones who live with the disease day in – day out,

  12. Francesca says:

    Shame people want to dis this. For the record I’m a national voter and have been for years. This meter is inconsistent with it readings and my 11 year old relies on a CORRECT reading to inject the CORRECT amount of insulin. My son is hypo unaware and as the psycho above may well know (or he should ask his mum because he’s not going to remember trying to adjust doses as a kid) you inject too much due to an incorrect reading, and you’re hypo unaware, you’re dead. That simple. This isn’t political, this is stupidity and a step back into the dark ages. 0.5 of a unit might not cause a problem for psycho but for young kid that’s enough to have them unconscious. These meters have been known to give you a reading 10 higher than the current meters. Glad psycho doesn’t have a problem playing roulette with others lives (just like pharmac, the medical professionals who had, at time of removing the funding for the freestyle light, had no idea of what it was or did that the others didn’t)

  13. Jana, type 1 mum says:

    I have tested one of the new meters and they are not suitable for a number of people.

    As mum, I don’t want these meters anywhere near children! The lid contains an easily accessible desiccant which is toxic.

    As mum, I don’t want these meters near teenagers! It is hard to get a child or teenager to comply with the tedious routine of test, bolus, eat, repeat of type 1 diabetes in the first place. These meters allow the patient to delete results and gives teenagers plenty of opportunity to falsify results.

    As aspiring nurse, I would not want any of these meters near any patient at the risk of hypoglycemia as I found they won’t pick up 25% of low levels.

    As friend, I would not want these meters near people with dexterity problems or having a hypo. The strips are tiny and the strip fill window is near impossible to see. This causes further problems during night time tests as I know have to use a flash light.

    As a science nerd, I would not want these meters as the cost saving is mainly achieved through applying a miniscule amount of the reactive chemicals to the strips instead of ensuring there is plenty to go around as with more common meters. Additionally the active ingredient providing the reading is one that is produced cheaper, but has been not only succeeded by other chemicals, it is also known to provide false readings when it reacts with oxygen.

    As a double business degree graduate, I would not want a sole supply agreement for a life saving devices such as a PoC blood glucose meter nor could I justify a saving today that will undeniably result in significant costs later.

    In a nutshell – back off Pharmac! It’s hard enough being a T1 mum and trying to achieve stable levels in a busy life. I do not want to worry more than I already do! I only want for my son to have a life!

  14. Psycho Milt says:

    Many of those who are now using a CareSens glucometer ARE indeed experiencing large discrepancies in their results.

    If so, and if the discrepancies genuinely reflect inaccuracy of the CareSens meter rather than other factors, we aren’t talking about a poor policy decision, we’re talking about negligence from Pharmac that could well be criminal. Instead of complaining on blog comments threads, assemble evidence of the inaccuracy of these meters and provide it to Maryan. Without that evidence, there’s nothing to distinguish your complaint from those of people merely annoyed Pharmac won’t buy their preferred product.

    Blarney stone and Psycho Milt either one or both of you must be a National MP or work for Pharmac, otherwise you would not be so outspoken in your comments to Maryan, who is the ONLY MP to take up the challenge and help people with diabetes.

    Er, I am “people with diabetes,” and it doesn’t help me at all to be presented as some kind of helpless invalid in imminent danger of dropping dead because I didn’t get my preferred blood glucose meter.

  15. Vanessa says:

    Psycho Milt…….it is not a matter of our ‘preferred’ blood glucose meter it is the fact that these meters are at best technically out of date and at worst glaringly inaccurate and dangerous. As for proving the inaccuracies we hit a brick wall in that individuals such as we are do not have access to labs or the equipment and expertise to do so. Pharmac will laugh all the way to Korea without scientific data to prove what we already know by using them on a daily basis in direct comparison. Tony Ryall is not aware of the differences between type 1 and type 2 Diabetes so I personally hold little hope of him as our Minister of Health comprehending the serious implications of a piece of medical equipment we rely on. You may not have any issue with trusting every blood glucose result enough to act upon but as mentioned above some T1′s have such sensitivity to insulin that half a unit can be the difference between very serious consequences.

  16. Jana, type 1 mum says:

    I am more than happy to show you the evidence of the meter discrepancies I found in person, Psycho MIlt.

  17. Jana, type 1 mum says:

    As for inaccuracy, I cannot prove clinical accuracy as I live in the real world, not in a laboratory. My son is a real child, not a non-hypoing 18-65 year old ‘lab rat’. We experience high and low temps, high and low humidity, bumps, knocks, low light, artificial light, bright sunshine …

    I am not sure if you are aware that the late addition N POP has never been tested in a laboratory setting, nor in real life circumstances, nor on children whose physiology is different, nor on people with hypos prior to FDA approval. And there is no LOW test solution for any of the CareSens meters available which means I can’t even check if they were accurate … I was unable to find the cited testing through ADA on the back of the strip instructions. These meters have not been tested in Heidelberg recently – a series of lab tests to compare a number of available meters against the new proposed tighter ISO requirements. All we have is i-Sens’ word and sorry, not good enough!

    I am a taxpayer. I should be able to expect that I have access to the medical products I want. Unfortunately what some people like you don’t understand – if it’s not funded or commonly prescribed/bought, it’s hard to get your hands on it. I don’t want the CareSens, I want the Performa. How am I supposed to get test strips if no one but me uses them? One of my acquaintances wishes to use an Accuchek Mobile and can’t because the strips are not available in NZ. Think about that!

  18. SO Type 1 for 16 years says:

    Psycho you may have not needed training on your meters but there are a lot of people who do. Yes I have worked out how to use all my meters myself but my 80 year old grandfather in-law who has memory issues is definitely going to struggle. Never mind the size of the strips will make it impossible for him to use. If you talk to the people who distribute meters such as pharmacies and diabetes Auckland they will tell you it can take an hour or more to train some people. Diabetes and in particular type 1 is a tough condition to live with and takes it toll each and every day. A meter is a life saving device and people choose a meter for a particular reason or reasons to enable them to live there lives as close to normal as possible. All we want is to be given the tools to manage our condition as best we can. Many diabetics also have multiple meters as back ups and in various places such as work and school. These meters have been purchased at our cost and our now redundant. We get 1 free meter meaning we will have to replace these other meters at our cost. Another issue is with the lancet provided. It is totally inadequate. Yes we can continue using our current lancet but the newly diagnosed will need to purchase these at their own cost if they are even aware they exist.

  19. Psycho Milt says:

    So, where we’re up to is:

    1. The basic requirement of a blood glucose meter is that it provides an accurate measurement of blood glucose.

    2. Failure to do so is not a matter of poor value for money, it’s life-threatening.

    3. If Pharmac has decided to fund a meter that fails to provide an accurate measurement of blood glucose, that would be not merely negligence, but life-threatening negligence.

    4. Some users of the Pharmac-funded meter say it is providing different results from known good meters.

    So: if the people in point 4 are correct, we have the situation in point 3: life-threatening negligence by a government agency. That’s a serious enough issue that Maryan Street or various media outlets could do something with it – if provided with actual data to back up the claim. Those who have encountered different results should record the results and make them available to Maryan and to Diabetes NZ, and should also try making a few phone calls to local media organisations.

  20. Type1 mum says:

    I agree with the last post by psycho milt. Definitely life threatening negligence by a government agency.

  21. Elizabeth says:

    Agreed Psycho Milt! Now you understand where these people are coming from. As for Diabetes NZ they said it “if this went ahead they would bring out the big guns,” So far they have made absolutely no contribution, the big guns are more like a resounding pop. As for the news media, way back in Aug/Sept TV3 did a small segment but let Pharmac talk their twaddle and if course 90% of the population believed them. Stuff.co.nz and some local papers did a few items but again not correct. Email back to me from MOH (Ryall) was a copy of Pharmac’s media blurb. So many people contacted Pharmac, got redirected to Pharmaco who in turn redirect to web site of Isens manufacturer of Crapsens meters and strips and then found out that Isens are tied up in litigation with another company over legal stuff re the test strips! Pharmac now roll out their so called roadshow and if you take your trusted existing meter to you chemist, Doctor or ed nurse then you get to swap said trusted meter for the new Crapsens so the majority of people wont be able to test both meters alongside each other. It is a matter of choice, Pharmac have taken away the choice of fully funded meters diabetics want to use. (Apologies for the length of this reply)

  22. Joy Z Clark says:

    My Mum is T1, (from age 35) I was diagnosed at 25 and now looks like my son in America at 24 is in the process of being diagnosed (slim fit young man as well) As the process over there is a bit slow we decided to send him a spare meter to use as he will be bringing it back to NZ so no one should have an issue with that….. there were two meters to chose from between Mum and me… a Care Sans and an Accu Chek…. Mum said to send my spare Accu Chek as the Care Sans is giving INACCURATE READINGS….. (she is a reg. nurse and long-time diabetes educator and uses a pump and tests at least 6 x a day so she does know what she is talking about) She did not want to risk lending something to he Grandson that was in fact so useless…. Thanx Maryan for all you have done and continue to do for us. Many of us are feeling wuite vulnerable right now.

  23. Joy Z Clark says:

    My Mum is T1, (from age 35) I was diagnosed at 25 and now looks like my son in America at 24 is in the process of being diagnosed (slim fit young man as well) As the process over there is a bit slow we decided to send him a spare meter to use as he will be bringing it back to NZ so no one should have an issue with that….. there were two meters to chose from between Mum and me… a Care Sans and an Accu Chek…. Mum said to send my spare Accu Chek as the Care Sans is giving INACCURATE READINGS….. (she is a reg. nurse and long-time diabetes educator and uses a pump and tests at least 6 x a day so she does know what she is talking about) She did not want to risk lending something to he Grandson that was in fact so useless…. Thanx Maryan for all you have done and continue to do for us. Many of us are feeling wuite vulnerable right now. I had a machine years ago reading too high… I could not understand why I was having severe hypos but the machine said 5 ??? Eventually I found out it was reading 4 too high by testing at the same time as venous testing was being done at the lab…. this was just downright dangerous as I was pregnant at the time. ACCURACY is critical when you are on insulin… it is a no-brainer….

  24. bbfloyd says:

    I feel the need to point out here, that one of the issues implied(quite obviously) is that pharmac has been subjected to a similar level of political interference to the ACC….

    As it is in the interests of the current raiding party to discredit pharmac in order to satisfy their owners desire for unfettered access to the health budget….and the profits that will ensue…..and, with the willing help of our “fourth estate”, a successful “ACC mk2″ is launched…

    So the best argument that can be thrown up is to ignore the obvious, drop any pretense at perspicacity, and point the finger loyally at pharmac as the originator of what is becoming a trend of faulty decision making?

    Have we all got our stupid hats on today? Good…let me tell you the story of the evil pharmacy troll…………

  25. Simon says:

    I wonder if there’s any correlation between the release of these meters and the doctor’s new edict to me that Ineed to start raising my blood sugars as they are worried about my hbA1c results being 48mg/dL (or 6 mmol/L whichever you prefer). I am currently on a drug trial for a new insulin and using a myglucohealth meter for the duration of the trial (I’ve been a diagnosed Type I diabetic for nearly 20 years) and whenever I check my results against both my Optium Exceed and CareSens the Optium reads a wee bit lower and the CareSens quite a bit higher. Like others who write here, that low figure could mean the difference between life and death for me, particularly as I ride a large motorcycle. I just don’t trust the new meter.