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11-07-2023

Good news for patients with diabetes: insulin pumps are now available for re-rent

Iliustracija

The Compulsory Health Insurance Council has approved changes to the procedure for renting medical devices. Under the new rules, insulin pumps for patients with type 1 diabetes who need them for home healthcare will be able to be not only replaced, but also re-rented to continue their treatment. Insulin pumps have been included in the reimbursement of the Compulsory Health Insurance Fund (CHIF) since June 2018. However, the current procedure stipulates that economic operators can lease a specific medical device for up to five years. Therefore, the first patients who received their insulin pumps five years ago and wish to continue using them will face problems in terms of repeat/continued treatment.

The Compulsory Health Insurance Council (CHIC) has approved the proposal of the National Health Insurance Fund (NHIF) under the Ministry of Health to continue to reimburse patients for insulin pumps at the end of the 5-year insulin pump rental period. However, the appropriateness of the re-provision of insulin pumps will have to be assessed by a consilium of doctors from healthcare institutions providing tertiary (children) or secondary (adults) inpatient and outpatient paediatric and adult endocrinology services. At least one endocrinologist or paediatric endocrinologist will be included in the consilium. 

An insulin pump can be prescribed to continue the treatment if: 

  • children with type 1 diabetes are referred to a paediatric endocrinologist at least 2 times a year;  
  • adults with type 1 diabetes are referred to an endocrinologist at least once a year;
  • insulin pump treatment improves disease control. 

CHIF has also supported a proposal by organisations of patients with diabetes to regulate the replacement of insulin pumps. It was agreed to impose a requirement that the type of insulin pump rented to a patient can only be exchanged for another type of insulin pump on the decision of a medical consilium if the patient's existing insulin pump is not performing its function, that is, if the control of the disease is not improving.  

The Health Insurance Funds would like to point out that the CHIF reimburses the cost of insulin pumps for patients with type 1 diabetes: children, adults, pregnant women and women planning to become pregnant. As well as patients on the waiting list for pancreatic islet transplants.  

According to doctors, the insulin pump helps people with type 1 diabetes to get closer to the same quality of life as if they had a healthy pancreas. The pump regularly releases a small amount of insulin around the clock, plus an additional amount with meals. For patients who have to use insulin, it helps to significantly reduce the number of insulin injections (pricks) and allows them to live a full life, reducing the fluctuations of glucose that put them at higher risk of complications. 

Insulin pumps are 100% reimbursed to people who are covered by Compulsory Health Insurance and who need it for home health care. The appropriateness of such treatment is determined by a consilium of doctors from a tertiary care institution providing inpatient and outpatient endocrinology services.  

After receiving a positive decision from the doctors' consilium, patients wishing to rent an insulin pump must contact a company that has a contract with the NHIF to reimburse the cost of medical devices needed for home healthcare. The company will sign a contract with the patient for the issuance of the insulin pump, the warranty, ongoing maintenance and the supply of spare parts. 

According to the NHIF, more than 900 patients were reimbursed for insulin pumps in the first quarter of 2023. The CHIF paid around EUR 600 000 for the rent of insulin pumps.

The new procedure for renting medical devices necessary for home healthcare will enter into force shortly after the Minister signs a decree. 

(Freepik photo)

The NHIF invites you:

Last updated: 09-08-2023

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