Australia’s health funds are extremely concerned about the rising prevalence of diabetes in Australia. Diabetes causes other debilitating chronic health conditions to develop, including heart disease, kidney failure, blindness and even dementia. Reducing the cost and improving the quality of treatment for people living with diabetes provides benefits to the individual, to health funds, to governments and to the community as a whole.
More than 300 people are diagnosed with diabetes every day and an estimated two million Australians are living with the condition. Private Healthcare Australia (PHA) welcomes recommendations to improve diabetes prevention and address the diabetes epidemic, contained in the House of Representatives Standing Committee on Health, Aged Care and Sport ‘Inquiry into Diabetes’ Report, The State of Diabetes Mellitus in Australia in 2024.
These include a levy on sugar-sweetened beverages; that government consider regulating the marketing and advertising of unhealthy food to children; explore the potential for a national diabetes screening program; and address equitable access to healthcare for people living with diabetes.
The Committee also recommended the Government undertakes a review of the price and choice of insulin pumps in Australia. In its submission to the ‘Inquiry into Diabetes’, Private Healthcare Australia calls for an immediate review of inflated insulin pump prices to improve access to this life changing therapy for people with diabetes and reduce costs on the Australian health system.
“Australians with private health insurance are paying exorbitant prices for insulin pumps, currently double what they should for this safe and effective technology. Health funds are one of the largest collective buyers of these devices, yet they are unable to obtain globally competitive rates due to the protected pricing system maintained by the Government’s Prescribed List of Medical Devices,” said PHA CEO Dr Rachel David.
The overpricing of insulin pumps was called out in the Report:
When the pumps were originally added to the list, they were new to the market. Since then, their price has decreased, but this is not reflected on the government prescribed list as pricing changes require a lengthy review process.
As Mr Ben Harris, PHA Director of Policy and Research, noted: …our system has a set and forget. So the market price was $8,000 when [the insulin pumps] were put on. The market price is now $4,500 and they’re still $8,000. According to PHA, one of the most common pumps in Australia costs Australians $8,574 while the same device costs NZ$4,500 for people in New Zealand.
“The Prescribed List artificially inflates the cost of insulin pumps and other medical technologies. In a cost of living crisis, with chronic disease on the rise, Australians simply cannot afford to be paying inflated prices. There is no medical reason Australians with private health insurance should be paying double the price for insulin pumps.”
“Health funds also want to be able to deliver a wider range of services to their members as part of Chronic Disease Management Plans. CDMPs help at-risk people avoid diabetes and its wide-ranging consequences or manage the condition to live a healthy, productive life and prevent hospitalisation”.
In its submission, PHA calls for changes to outdated regulation currently prohibiting health funds paying for nurses and nurse practitioners to provide CDMP services. This is out of step with best practice. With nearly one in two Australians living with a chronic health condition, and amidst a medical workforce shortage, we need to remove these restrictions and fully utilise the skills of nursing professionals.
“In a cost of living crisis and with health expenditure increasing unsustainably, the commitment of our Federal Members of Parliament to the prevention and better management of diabetes should be applauded. Changes to ensure we are investing in the right things to keep people well and out of hospital are well overdue. The time to act is now,” said Dr David.
