March 3, 2025 – Quebec – Breakthrough T1D Canada is calling on the Quebec government to adopt the 2022 INESSS recommendation to eliminate current age restrictions on public coverage of insulin pumps and extend access to all ages.
Universal access to technologies for type 1 diabetes (T1D), such as insulin pumps, has been shown to ease the burden of disease, improve the health outcomes of those who use them, and reduce overall healthcare costs. Recognizing these benefits, Canadian provinces and territories have made considerable strides in recent years to provide or expand public access to these critical diabetes technologies.
Quebec is now the only province in Canada with age restrictions on public coverage of insulin pumps.
An estimated 67,500 people in Quebec live with T1D, a chronic autoimmune disease triggered by the immune system mistakenly destroying insulin-producing beta cells in the pancreas. Over 40,000 of them are adults. As there is no cure, T1D is a lifelong disease that requires 24/7 management. T1D has a considerable impact on the physical, mental and financial well-being of a person living with this disease, and even with careful management can result in long-term complications like blindness, kidney disease, amputation and can even be fatal.
Research shows that 71% of new diagnoses of T1D occur in adults, and over 80% of people living with T1D are over the age of 18. Since Quebec’s Insulin Pump Access Program only covers insulin pumps for people diagnosed and registered before the age of 18, this leaves many Quebecers without adequate coverage.
The financial cost of living with T1D can be on average up to $15K per individual without coverage. This can add significant financial burden and impact the type of treatment a person with T1D can use based on what they can afford. Also, at age 65 and over, no other insurance covers T1D costs, which will have a major impact on quality of life, increasing stress and anxiety.
The Lepages are a family with three adult children who have all been diagnosed with T1D.
“If we consider the impact on a family having three of their kids with T1D, it is important and necessary that they all have access to the same treatment options for their diabetes. The insulin pump gave us flexibility and a better quality of life as parents with three kids, who were all different ages and who had different needs, such as with sports, arts, activities, etc.,” says Mr. Lepage.
Two of these young adults are covered by the Insulin Pump Access Program in Quebec because they were diagnosed under the age of 18, but the third was diagnosed at 19 and is therefore not eligible for public coverage like his siblings. Even though they’re all adults, only 2 of the 3 are covered because they enrolled while under 18 and are in the program for life. The older gets no pump coverage at all – simply for being diagnosed with T1D at age 19.
“When my son was first diagnosed at 19, because he was still a full-time student, it was possible to support him getting an insulin pump through my company employee health care insurance. But when he turned 25, the coverage stopped even if he was still at school. But since he had entered the labour market, no other assistance was available. This disease is there for the rest of his life and the costs related to the insulin pump are significant. He is in the same situation as his brother and sister, he must treat himself every day, continuously, and that is for the rest of his life.
Right now, an insulin pump is the best option for him to maintain blood glucose levels in a range that helps keep him feeling well and that minimizes the risk of future diabetes-related complications. For all three kids, the insulin pump was the best way for them all to maintain good glycemic control and manage their T1D. With the insulin pump, all three have never been hospitalized for severe hypoglycemia and/hyperglycemia (dangerous low and high blood glucose levels that can result in death if not treated immediately). We have daily proof of the importance of these insulin pumps in their lives. So, it is essential that our older son too have access to a public coverage program and not be denied simply because of when he was diagnosed,” says Mr. Lepage.
Reducing waiting times in Quebec’s emergency rooms and improving access to primary care has long been a priority for Quebec. Insulin pumps make managing T1D easier and improve health outcomes, which could lead to a reduction in the number of emergency room and hospital visits, and the risk of long-term complications.
Removing the age restriction on public coverage of Increasing public coverage of technologies such as insulin pumps and advanced glucometers is a sensible approach to helping Quebecers living with T1D better manage their disease, while avoiding hospitalization and helping to better meet the needs of rural and northern residents.
As Quebec seeks to improve its healthcare system, it must ensure equitable access to these life-saving devices, regardless of the age of diagnoses. Insulin pumps are a valuable tool to help people manage their T1D and avoid serious medical episodes and long-term complications.
“Good glycemic control and T1D management by using an insulin pump and the newest diabetes technologies combined with exercise and meal planning etc., all have a positive effect on life expectancy and lowered complication risk. That is possible for my kids if they have access to the insulin pump treatment. There is no reason to discriminate by age who has access to an insulin pump and that two of my children can use it, while a third must administer insulin to himself with multiple daily needle injections,” says Mr. Lepage.
Quebec’s Insulin Pump Access Program is available to children under 18 years of age, and they may continue to participate in it after age 18 if they still meet the clinical eligibility criteria. Eligibility for the program must be re-evaluated annually for people over 18 years of age.
Anyone who is diagnosed and/or enrolling in the program after age 18 however, is not eligible for reimbursement of pumps and accessories.
Last year, Prince Edward Island joined New Brunswick and Nova Scotia in extending public coverage of insulin pumps to all ages. This means that Quebec is now the last province in the country without insulin pump coverage for all ages.
About Breakthrough T1D Canada
As the leading global type 1 diabetes (T1D) research and advocacy organization, Breakthrough T1D helps to make every day better for those living with the disease while driving toward cures.
Since the discovery of insulin, Canada has remained at the forefront of T1D research. Breakthrough T1D is committed to investing in the most promising research, advocating for progress by working with governments to address issues that impact the T1D community, and supporting individuals facing this disease.
For more information:
Ruth Kapelus
National Content and Media Relations Manager
T. 647.789.2322
E. rkapelus@breakthroughT1D.ca
BreakthroughT1D.ca
