Diabetes Canada warns against stockpiling, panic-purchasing of insulin amid COVID-19 pandemic

Despite concerns heard during the COVID-19 pandemic, Diabetes Canada says there is enough insulin to go around, but those who require it will need to fill their prescriptions in smaller batches.

Across the country, pharmacies are now filling most prescriptions monthly as opposed to every three months. For many, this causes anxiety and means paying more out of pocket. 

"They're worried about being able to continue to access insulin. Insulin is life-sustaining for people living with Type 1 diabetes and some people living with Type 2 diabetes," said Seema Nagpal, Diabetes Canada vice-president of science and policy.

"We are very aware of these concerns and absolutely understand and have compassion for people who are very fearful that insulin supply may run out."

Nagpal said Diabetes Canada has contacted insulin manufacturers and have been reassured that there is enough in Canada for people's needs. 

Living with a chronic disease is challenging and particularly stressful in our current environment.— Erin MacKenzie, P.E.I. Pharmacists Association

"We have also heard that at some local pharmacies that a particular supply of insulin has been disrupted, meaning that when a patient goes into that pharmacy that they didn't have that insulin on hand," she said. 

Nagpal said if this happens, patients should still be able to access insulin at a pharmacy nearby.

"Those supply disruptions really should be temporary, and as we see people perhaps adjust to only filling their prescriptions for 30 days, we should see these supply disruptions stop happening," she said.

P.E.I. says no shortages or disruptions

The P.E.I. Pharmacists Association said it has not seen any insulin shortages or disruptions.

"Living with a chronic disease is challenging and particularly stressful in our current environment," said executive director Erin MacKenzie in an email to CBC News. 

"Medication supply management is just one more thing that we are doing, in the best interest of all of our patients, and the public's understanding that this is crucial at this time is appreciated."

In Canada, dispensing fees can range from about $4 to $15 per prescription, depending on the pharmacy and province. In P.E.I., some have said the dispensing fee of $12.36 for clients of government drug programs is "one of the highest reimbursed fees in Canada."

We believe that the financial burden of this policy shouldn't fall directly on patients.— Seema Nagpal,  Diabetes Canada 

In addition to dispensing fees, many Canadians also pay co-pays and deductibles for each prescription through their private or public drug plan. For individuals who have multiple prescriptions needing to be filled every 30 days instead of every 90 days, those costs are paid three times as often and can add up quickly.

"It's just hard for some patients to be able to pay that out of pocket at this time," Nagpal said, referring to how the economic impacts of the pandemic have affected so many people.

"We believe that the financial burden of this policy shouldn't fall directly on patients. So we'd like for governments, for insurance companies and pharmacies to work together to really ensure that both the supply chain is secured, but also that the financial burden doesn't fall on patients."

MacKenzie said that in P.E.I., the provincial government has worked with the pharmacy association to support the 30-day supply move, and that provincial pharmacare recipients will not have to pay additional co-pays.

In a news briefing on Friday, Health PEI chief of nursing Marion Dowling said they share in the concerns about the stability of the global supply chain for prescription drugs, and have been in touch with drug vendors and suppliers on the issue. 

'Someone else may not have access'

"Any stockpiling or panic-purchasing of insulin should really be avoided, because doing so means that someone else may not have access," said Nagpal. She also said she understands the discomfort those with diabetes could feel from having what they may consider a low supply of life-sustaining medication.

"We really encourage people to have one or two weeks' supply of insulin on hand and that we make sure that we're not stockpiling in order to preserve the supply for everybody."

Nagpal said that despite the increased cost to patients, Diabetes Canada wants to ensure that pharmacists are still paid for their valuable work.

Dispensing fees cover a variety of expenses for pharmacists, including the time it takes to verify prescriptions, talk to patients and track inventory and patient records. 

The Canadian Pharmacists Association said there are no known drug shortages as a result of COVID-19, but demand for prescription drugs was up 30 per cent in early March.

"Pharmacists, along with technicians and staff, are showing up every day on the front lines of health care during an incredibly challenging time," said MacKenzie.

"In addition, we are assuming many more responsibilities as services elsewhere in the system are being reduced due to the move to essential-service delivery within Health PEI."

As for managing diabetes during a COVID-19 outbreak, Nagpal said it is important to stay hydrated, practise sick-day management and be especially aware of signs and symptoms of hypoglycemia and hyperglycemia, as well as triggers for changes in glucose levels, such as shifts in sleep and dietary patterns and stress levels. 

COVID-19: What you need to know

What are the symptoms of COVID-19?

Common symptoms include:

• Fever.
• Cough.
• Tiredness.

But more serious symptoms can develop, including difficulty breathing and pneumonia, which can lead to death.

Health Canada has built a self-assessment tool.

What should I do if I feel sick?

Isolate yourself and call 811. Do not visit an emergency room or urgent care centre to get tested. A health professional at 811 will give you advice and instructions.

How can I protect myself?

• Wash your hands frequently and thoroughly.
• Avoid touching your eyes, nose and mouth.
• Clean regularly touched surfaces regularly.
• Practise physical distancing.

More detailed information on the outbreak is available on the federal government's website.

More COVID-19 stories from CBC P.E.I.