Vicky Ferrante, RD, CDCES, a dietitian and diabetes educator at Cheshire Medical Center, is on a quest for health equity for diabetes patients. This past year, she led a successful effort to convince New Hampshire Medicaid to expand its coverage of diabetic tools, which help patients manage their diabetes.
Prior to Ferrante’s efforts, N.H. Medicaid ruled it would not cover the cost of a new tool, known as the InPen. This meant many patients Ferrante worked with would not have access to this new technology.
“They would be told they have to pay out of pocket for something that’s very expensive,” she said.
The InPen utilizes Bluetooth technology to calculate insulin doses and logs them on a smart phone app, preventing patients from mistakenly giving themselves an extra dose. It also tracks insulin levels throughout the day and calculates the carbohydrates in a meal.
Most commercial insurance programs, as well as N.H. Medicare, cover the cost of the InPen, but Medicaid did not.
Without insurance, the pen is priced at $549, which is not affordable for Medicaid recipients. The manufacturer, Medtronic, has a program where people can pay just $35 for the pen. But, Ferrante said even that is too much for many of her patients.
“They are faced with questions like, ‘Do I get that or get food? Do I get that or pay my heating bill?’ It shouldn't be a decision that you have to make,” Ferrante said.
Ferrante began circulating a petition to doctors, nurses and educators at Cheshire and the Dartmouth Health system to convince N.H. Medicaid to cover the InPen.
In the petition, it was noted that not having access to insulin can lead to complications like amputation, kidney disease, blindness and heart attack—costly health conditions that Medicaid would have to pay for. After she submitted the petition last fall, N.H. Medicaid opted to cover the InPen.
“I jumped for joy,” Ferrante said. “The situation with my patients is familiar, so it goes right to my core. It’s inspired a huge passion in me.”
Ferrante lives with type 1 diabetes and understands the challenges her patients face with affordability. During a time when she didn’t have health insurance that covered insulin, she struggled to pay the monthly cost of $1,000.
Her work extends to helping all patients who have difficulty affording insulin even with health insurance. She works to get them manufacturers’ coupons or referred to Dartmouth Health’s Medication Assistance Program (MAP). MAP, which has eligibility requirements, helps patients obtain medications from pharmaceutical companies, either free or at a reduced cost.
“Our patients need these tools and resources to manage their diabetes and to be healthy,” Ferrante said.
In just the last nine months, more than 100 of Cheshire’s type 1 and type 2 insulin-dependent diabetes patients were put on insulin pumps, insulin patches or smart pen technology with the program.
Ferrante’s next quest is to petition Vermont Medicaid to cover the InPen. She has already petitioned Massachusetts, and in the near future, when the newly designed insulin pumps come on the market, she’s ready to petition for those to be covered as well.
“I will petition whoever I have to for my patients,” she said. “I just don’t stop.”
Ferrante encourages Cheshire patients with diabetes to reach out to their provider if they are having difficulty affording medication or are in need of resources to help with their diabetes goals.
For more information on Cheshire’s diabetes education program, visit cheshiremed.org/diabeteseducation.