Family critical of N.L. prescription drug program

Andrew
Andrew Robinson
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Matthew Batten, 13, is shown with his insulin strips and liquid insulin at his Foxtrap home Wednesday evening. Matthew has Type 1 diabetes. His parents Kim and Steve have been trying for almost the past year and a half to have the Newfoundland and Labrador prescription drug plan cover a percentage of the costs associated with his diabetes

Matthew Batten, 13, learned he had Type 1 diabetes 17 months ago. His parents found it hard to pay for the prescription medication he needed to live, but they were better able to handle the costs with help from the Newfoundland and Labrador Prescription Drug Program (NLPDP).

But after April 30, the Battens will no longer receive assistance according to a letter they recently received stating they do not qualify for coverage.

Kim Batten, Matthew's mother, said the province should have a specialized drug plan in place for diabetic children, particularly given the disease's prevalence in the province.

"It's a terrible system," she said. "This is for my child - without insulin, he doesn't live."

Matthew, who was equipped with an insulin pump in January, needs to check his sugar levels eight to 10 times each day. Test strips cost $1 each. A vial of insulin costs $35 and lasts one week. He also takes a medication for anxiety costing $60 per month.

According to Kim Batten, the cost of his prescriptions from Jan. 11, 2011 to Dec. 19, 2011 was $2,961.79. The Battens also have a nine-year-old son named Stephen.

When Matthew was first diagnosed, Kim Batten said she knew immediately they would have trouble paying for his prescriptions. Steve Batten said staff at the Janeway Children's Hospital told him diabetics are almost guaranteed assistance at some level through the NLPDP.

"Of course, the door shut in our face," he said.

Recipients must apply every six months for the program.

The Battens took their case to Conception Bay South MHA Terry French, and were subsequently able to receive assistance for 43 per cent of the costs associated with Matthew's prescriptions.

"Which is a help," said Steve Batten. "We're not looking for handouts. We're looking for that little bit extra. ... We're only a regular family. We're not making big money. We're just getting by."

Kim Batten is a daycare worker, while Steve Batten is a mechanic. They do not have health insurance.

Aside from the burden of paying for Matthew's prescriptions, Steve Batten said it is costly to provide him with the healthy diet he requires as a diabetic.

Under the NLPDP Assurance Plan, individuals and families with a net income of $40,000 to $74,999 will pay a maximum of 7.5 per cent for eligible prescription drugs. The Battens net income falls in this range, and they say the percentage cap should be lowered.

Kim Batten said she has contacted French, local Member of Parliament Scott Andrews, Minister of Health and Community Services Susan Sullivan and NDP leader Lorraine Michael.

Changes were made to net income thresholds for the Access Plan in the 2010 budget to respond to an increase in the minimum wage, which otherwise may have resulted in some residents becoming ineligible for the program.

According to the province, it invests approximately $148 million annually in the NLPDP.

A spokeswoman for Health and Community Services said the budget for the NLPDP is based on provincial demographics and the expected incidence of illnesses and medicals conditions. She said the thresholds are applied to all applicants, and if an applicant does not agree with a decision, it can file an appeal.

The spokeswoman said access to health insurance does not factor into an applicant's eligibility, adding the NLPDP is the only public option for subsidizing the cost of prescription drugs.

arobinson@thetelegram.com Twitter: TeleAndrew

Organizations: Janeway Children's Hospital, Community Services Susan Sullivan, Health and Community Services

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Recent comments

  • Dianna K. Goneau Inkster
    March 24, 2012 - 20:40

    I don't quite understand the NL public plan. Ask yourself this however: how much of your tax dollar (provincial or federal income tax, provincial sales tax, license fees (car, boat, property tax, driver's license)) goes to subsidize a teacher's, a police officer's, a fireman's extended health benefits. It seems to me even when I was a teacher in NL in the '70s that we had drug coverage. Now that my husband, 65 is a type 1 diabetic and has secondary Addison's disease in Ontario I can only hope that we continue to enjoy the great drug coverage we have now. I say if you are paying for other families' drugs you should scream bloody murder if your high cost prescription drug needs are not being funded. Good luck, little guy! God bless!

  • mary
    March 18, 2012 - 19:35

    "Under the NLPDP Assurance Plan, individuals and families with a net income of $40,000 to $74,999 will pay a maximum of 7.5 per cent for eligible prescription drugs." So, individuals and families only have to pay, at most, 7.5% of the costs? I assume that if someone pays the top amount of 7.5%, then, they are making the higher wages. That is a pretty good deal considering it is coming out of public funds/taxpayers dollars. There are many who have to adjust their diets for health reason and eating healthy isn't a lot more expensive. Sometimes it is just a matter of eating less of the unhealthy stuff. No more supersizing, no more junk food.

  • Sam
    March 18, 2012 - 17:52

    I have health insurance and my premiums alone for health and dental coverage for me and my family is over $1900....and that's the government plan. That doesn't cover braces and some common medical things. I still pay the dispensing fee of $5 or $6 per prescription and about 20% of all of the other services we get. Health and drug coverage is expensive whether or not you're covered by a plan.

  • Jim a diabetic
    March 18, 2012 - 12:06

    I thought the government has a bit more compassion for children. I had to pay a good portion of mine until I turned a senior. Even now they try to nickel and dime it on test strips. I use injections and that can be 6 time a day. I have to test each time to see if I am high or low. The restrictions are on the ones that can least afford them. I wonder if there is anyone in the ministers family with diabetes, doubt it very much. I think personally it is about the time the Diabetic association got on the ball and used some of their resources to help children.

  • J
    March 17, 2012 - 20:12

    I pay enough taxes in an average year so I certainly don't want to be funding any national pharmacare program. I have never been on social assisstance or EI and have been in the workforce over 18 years so as a taxpayer I say enough - we, the taxpayers can't fund everything.

    • no free ride
      March 18, 2012 - 22:16

      Those of you "taxpayers" out there who are "paying" for these programs should be a little more grateful that you have had the ability to work and pay taxes. It is the inability to pay for the meds and various other treatments that can help keep one healthy and functional that prevents many from working. Treatments such as chiro and massage aren't even covered at all and physio thru mcp is over a year wait. I'm tired of "taxpayers" acting like they are better then others. One accident, one serious illness, one genetic disorder and your entire life could have been different. I've been a taxpayer, working 60 hours a week but I also know what it is to have your body not cooperate. So "taxpayers" who feel put upon I will show you more compassion then you have shown those like me...I hope you never suffer such poor health that you learn how it feels to be in this situation. I would gladly work 60 hours a week again if I could because that would mean I was able to do other things as well...like walk my dog, visit a friend. Its no free ride...in fact it goes nowhere...and neither do I. Be thankful for your health, your ability to work and pay taxes and have a heart.

  • Donna
    March 17, 2012 - 19:00

    Even social services recipients aren't guaranteed full coverage for diabetes meds anymore. That changed as of January passed. Being in the lower tax bracket myself I still have to get all kinds of paperwork filled out by a physician in order to help supplement some of the costs associated with diabetic meds that I need. You have to fight for life saving meds & strips no matter what your age is. To me living in Newfoundland as a diabetic is a death sentence. Once upon a time it used to be a death sentence once you were diagnosed with diabetes. Now they have all of these new drugs available and we still have to fight for our lives. Maybe I'm wrong but you can't avail of the tax break if your not on insulin. Forget it if you are trying to eat as a diabetic should.

  • Edward Sawdon
    March 17, 2012 - 17:13

    Matthew Batten's situation is another reason why we should have a National Pharmacare Program! While the Newfoundland and Labrador Government made some improvements in the NLPDP, there are still many residents who are not covered. Under a National Pharmacare Program, it is my expectation that all Canadians, and Newfoundlanders & Labradorians, especially those of us who don't have a other private nor public insurance, receive assistance of these life essential drugs. Unfortunately, the Harper Conservatives have a "do nothing" policy in respect to the most recent National Pharmaceutical Strategy and the National Pharmacare Proposal.

  • nel
    March 17, 2012 - 13:21

    hope my comment is of some financial comfort : PWD ( people with diabetes ) can apply with help from Doc and signing forms , while showing , that diabetes management requires a min of 14 hours weekly : Disability Tax credit http://www.cra-arc.gc.ca/E/pbg/tf/t2201/

  • doingwithout
    March 17, 2012 - 09:49

    I'm single & most of my income goes to housing. my net income is less than $1500 a month. I am still unable to afford my prescriptions so I do without. If I were able bodied & receiving social assistance my medications would be free! I suspect this program is "designed" to give with one hand & take away with the other! Many of us are still going without treatment whilst millions of dollars are being spent,,,you know what I mean!

    • Better than it was
      March 17, 2012 - 12:40

      Up until 4-5 years ago there was NO low income drug program. There was a plan for senior's recieving the Guaranteed Income Supplement and a plan for Social Assistance recipients. If your income is drug costs are not more than 7.5% in this income bracket than you don't get coverage.

    • gord k
      March 17, 2012 - 12:49

      they should have the same coverage as the do in ontario prescription payment assitance no mater your age or income

  • Marlene
    March 17, 2012 - 07:55

    I do not and will never understand this drug program. I have a 7 yr old who has asthma and her medications is not covered either but we have drug addicts out there getting there oxys and other narcotics covered just so they can either go sell it for better or snort it on side streets. Go figure. One day the government will get there priorities straight i hope.