John McGahon (Fine Gael) | Oireachtas source

I thank the Minister of State for coming to the House. I have raised this issue previously in Commencement debates over the years and I am taking this opportunity to do so again. Diabetes patients can only access FreeStyle Libre if they are under 18 years of age, rather than on the basis of clinical need. This product is widely available for those with diabetes up to the age of 18. Once the patient reaches this threshold, he or she is removed from this treatment, other than in exceptional circumstances, and is provided with a different treatment. This is notwithstanding the patient's familiarity with and usage of the existing FreeStyle Libre product. The removal of the patient from the treatment they know best is based solely on age considerations rather than clinical need or suitability for this product. That is the key issue here. The issue affects a significant proportion of the Irish population, including many people whom I have come across in County Louth. There is a failure to make FreeStyle Libre available for all patient cohorts, irrespective of age, and to reimburse the product more generally.

I would like to make a couple of points. Having a choice of technology is critical. It should be a case of the right technology for the right patient at the right time, or of the technology that meets the clinical needs and preferences of the patient while considering the functionality of the device. Access is not to be determined primarily by an age criterion. Currently, only a small portion of the type 1 diabetes population in Ireland aged between four and 21 years is funded for FreeStyle Libre, which accounts from approximately 14% of the type 1 diabetes population. While funding is in place for another similar-sized cohort of people with type 1 diabetes to access other continuous glucose monitoring systems, these options are considerably more costly. This leaves roughly 20,000 people who have type 1 diabetes in Ireland without access to glucose monitoring technology, which has become a standard of diabetes care right across Europe.

Ireland is behind the rest of the world in terms of diabetes care. Some 44 countries worldwide, including Great Britain and Northern Ireland, now reimburse FreeStyle Libre for intensive insulin users. However, in Ireland it has been six years since the primary care reimbursement service, PCRS, undertook a health technology assessment group appraisal of the product. All these years later, there is no further certainty or clarity for patients. The reimbursement of FreeStyle Libre for people with diabetes is significant because it allows for the remote monitoring of their condition. That is really key because it frees up much-needed doctor and hospital appointments, and leads to better management of the condition, improved outcomes and a better quality of life. Glucose monitoring systems enable individuals to monitor their blood sugar levels more closely, thereby reducing the risks and lowering the incidence of diabetes-related complications.

These technologies have become a fundamental part of diabetes care in many countries. Access to them should be considered as a real right for people living with diabetes. I do not believe that discriminating against them in terms of age makes sense. It does not make sense to me that children who commence their treatment on this device see themselves forced, at the age of 18, to simply switch over to another treatment process by virtue of their age. A survey of diabetes patients in Ireland highlighted the frustration of many people with diabetes who are unable to start, or who have to stop using, flash glucose technology to a lack of reimbursement and unaffordability. This issue impacts not only the individuals with diabetes who are unable to access this really important technology, but also their families and the wider community. As policymakers, it is our responsibility to ensure our healthcare system is providing fair and adequate access to vital medical technologies in a timely manner. With that in mind, I bring this issue to the Seanad today. I hope we can find a timely solution for all patients with diabetes in this country.