In Big Win for JDRF’s Coverage2Control Campaign, Anthem Decides to Cover Artificial Pancreas Systems
— America’s 25 largest health insurers now all cover this breakthrough diabetes technology —
NEW YORK, November 17, 2017 – JDRF, the leading global organization funding type 1 diabetes (T1D) research, today announced that its Coverage2Control campaign swayed Anthem, America’s second-largest health insurance company, to cover artificial pancreas (AP) systems. Anthem changed its policy after engaging with JDRF, hearing from the T1D community, and closely evaluating additional scientific literature that shows this technology is helping people with T1D be healthier. In a major milestone, America’s 25 largest health insurance companies now cover the first hybrid closed-loop AP system.
AP systems monitor blood glucose levels and automatically provide the right amount of insulin — a revolutionary advancement that dramatically reduces T1D-related complications and risks. But they are largely out of reach when not covered by insurance, due to their out-of-pocket costs. Anthem’s 40 million members now have covered access to this life-saving technology.
“This is a great victory for the T1D community. By taking this tremendous step, Anthem is giving its members with diabetes access to this breakthrough in diabetes management,” said Derek Rapp, president and CEO of JDRF. “I am so proud of how thousands joined our Coverage2Control campaign to help make this happen. We applaud Anthem for this decision, and will continue to push insurers to make changes to coverage that enable better diabetes management, such as keeping out-of-pocket insulin costs predictable and reasonable.”
JDRF launched the Coverage2Control campaign in May to urge insurance companies to provide coverage that works for people with diabetes. Within months, the campaign created a swell of momentum. Twelve health organizations —including leading endocrinologist and diabetes educator groups — joined as campaign partners, more than 50,000 people signed a petition that JDRF then delivered to the nation’s 25 largest insurance companies, and thousands more people have been using a grassroots platform to send personalized letters to their insurers. JDRF also reached out to executives at the 25 largest health insurance companies to have direct conversations about their coverage policies.
This announcement demonstrates the power of the T1D community’s collective voice: A major health insurer has adopted a policy that offers a new path for managing diabetes.
Anthem now meets three of the tenets of the Coverage2Control campaign: affordability, choice and coverage. It includes insulin on its preventive medicine list, which helps keep out-of-pocket costs for insulin predictable throughout the year. It does not enter into exclusive contracts with medical device providers, giving people the freedom to choose the tools they use to manage their diabetes. And now, it covers artificial pancreas systems.
Along with Anthem, other insurance companies offering three of the Coverage2Control tenets include: Aetna; Blue Cross and Blue Shield plans of Alabama, Florida, Massachusetts, Minnesota, North Carolina and Tennessee; Health Care Service Corporation; Humana; Kaiser Permanente and Medica Health Plans. JDRF will continue working with these plans, and with employers, to urge additional actions to make insulin more affordable, including encouraging benefit designs with fixed dollar co-pays, rather than co-insurance, and ensuring insulins are on tier 1 or tier 2 benefit levels where out-of-pocket costs are lower.
The first AP system came to market in 2017 after years of research and clinical trials. Over the past decade, JDRF has championed the development of AP technology through direct funding and collaboration with academic, research, government and industry partners — including advocating for the government’s primary research program, the Special Diabetes Program — which expired on October 1. JDRF is actively working on its Congressional renewal.
JDRF will continue to work with insurance companies, urging them to regularly review and improve their coverage policies as new technology and therapies become available, and additional AP systems come to market.
Already, many next-generation AP systems are in development. As technology advances, these systems will become better and better at predicting blood glucose changes and providing tightly controlled insulin dosing that virtually eliminates life-threatening hypoglycemic and hyperglycemic episodes. It’s crucial that insurance companies cover these systems — and not limit coverage to one brand — when they are FDA-approved and when evidence warrants coverage. Coverage and accessibility of breakthrough T1D treatments are life-saving and essential, while JDRF works with its partners and researchers to unlock the science for a cure.
People in the T1D community can continue to send letters directly to their insurer in less than 60 seconds using JDRF’s online platform. To stay updated and find other ways to engage in the campaign, visit Coverage2Control.com.
Type 1 diabetes (T1D) is an autoimmune disease in which a person’s pancreas stops producing insulin, a hormone that enables people to get energy from food. It occurs when the body’s immune system attacks and destroys the insulin-producing cells in the pancreas, called beta cells. While its causes are not yet entirely understood, scientists believe that both genetic factors and environmental triggers are involved. Its onset has nothing to do with diet or lifestyle. There is nothing you can do to prevent T1D, and — at present — nothing you can do to get rid of it.
JDRF is the leading global organization funding type 1 diabetes (T1D) research. Our mission is to accelerate life-changing breakthroughs to cure, prevent and treat T1D and its complications. To accomplish this, JDRF has invested more than $2 billion in research funding since our inception. We are an organization built on a grassroots model of people connecting in their local communities, collaborating regionally for efficiency and broader fundraising impact, and uniting on a national stage to pool resources, passion, and energy. We collaborate with academic institutions, policymakers, and corporate and industry partners to develop and deliver a pipeline of innovative therapies to people living with T1D. Our staff and volunteers throughout the United States and our six international affiliates are dedicated to advocacy, community engagement and our vision of a world without T1D. For more information, please visit jdrf.org or follow us on Twitter: @JDRF.