* Associate Professor Ben Wheeler (PI)
*Associate Professor Rhiannon Braund
*Professor Barbara Galland
*Dr Matt Healey
*Dr Jinny Willis
*Associate Professor Craig Jefferies
*Dr Sarah Boucher
Identifying demographic characteristics of patients who discontinue insulin pump therapy
Insulin pump therapy is publicly funded in New Zealand via the special authority scheme set out by the New Zealand Pharmaceutical Management Agency (PHARMAC). Patients must meet certain criteria in order to obtain government funding for their insulin pump. They also have to reapply in nine months to renew this eligibility. If patients fail to meet certain treatment targets as specified by PHARMAC, they may have their insulin pump therapy funding taken away.
This project aimed to identify groups who may be more likely to discontinue insulin pump therapy, and we expect that characteristics such as age, ethnicity, and deprivation will be associated with this. Identifying demographic characteristics of patients who discontinue insulin pump therapy will enable us to offer targeted education or more support to ensure patient success with this important but expensive therapy.
The study results
Since funding for this insulin pump was introduced, access had considerably expanded. Overall, uptake of insulin pump therapy in New Zealand was at 11.3% by end of 2016 (up from 1.6% in 2012), but was still low compared to 40% in the US, 38% in Canada and 16% in Italy.
Several sociodemographic disparities in access to the pump were identified. When controlled for all available variables, these included differences in utilisation by DHB, age, gender, ethnicity and socioeconomic position.
Māori and Pasifika, as well as youth, were over-represented in the cessation of pump use in comparison with Europeans and all other age groups. These groups are also less likely to gain initial access to public funding. Efforts to understand and reduce these disparities are needed, as well as a review of current public funding access criteria.
Read the papers
Hennessy LD, De Lange M, Wlitshire EJ, Jefferies C, Wheeler BJ. Youth and non-European ethnicity are associated with increased loss of publicly funded insulin pump access in New Zealand people with type 1 diabetes. Diabet Med. 2020 Nov 1:e14450. doi: 10.1111/dme.14450.
Wheeler BJ, Braund R, Galland B, Mikuscheva A, Wiltshire E, Jefferies C, de Lange M. District health board of residence, ethnicity and socioeconomic status all impact publicly funded insulin pump uptake in New Zealand patients with type 1 diabetes. N Z Med J. 2019 Mar 8;132(1491):78-89.