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[IP] Re: How does it work in your contry?

Greetings, Nicolas,

I believe the answer to your question has much to do with who their health
insurance provider is in the U.S., as well the patient themselves.  Insurance
in countries where there is not a single, government provided health insurance
plays a significant role in the decision, because of the significant cost
involved.  Different health insurance providers generally pre-negotiate
"preferred supplier" arrangements with major medical equipment suppliers (for
items such as insulin pumps) pharmaceutical manufacturers/drugs, home
diagnostics, etc.  Therefore, if the patient wants to ensure that the
significant expense of their pump is paid for by their insurance company, they
will likely choose one from a preferred supplier that the insurance company
has pre-negotiated pricing with.

The pump companies themselves can negotiate directly with the insurance
companies on the patient's behalf, and in some cases, they may be able to
settle on a price for the pump that is comparable to the preferred provider,
therefore the pump company may be able to negotiate coverage for the pump. 
Personally, my insurance company had preferred provider arrangements with both
Minimed and Disetronic, although coverage for another pump could be negotiated
outside of these arrangements if it was done so in advance.

The educators at my endocrinologist's office were all Minimed trainers and
naturally had a preference for me to use a Minimed pump.  That, along with the
preferred provider status for Minimed pumps with my insurance company, might
have influenced the decision for a less demanding patient.  However, I
insisted on doing a saline trial with all pumps that were available because I
was the person who had to live with it 24 hours a day/7 days a week/365 days
per year.

Interestingly, all of the pump manufacturers EXCEPT Minimed (now Medtronic
Minimed) agreed to allow me to do a saline trial of their pumps.  I was told
by the sales rep that they do not do saline trials, although I do not believe
that is true.  The Sooil/Dana pump, Deltec Cozmo, and Nipro Amigo pumps had
not yet received U.S. Food and Drug Administration approval to sell their
pumps in the United States when I was choosing my pump.

Medtronic Minimed, in my opinion, had grown arrogant in the belief that they
were the biggest and they had already pre-negotiated insurance coverage with
virtually all of the major insurance companies, so they felt less of a need to
actually "sell" me their pump.  That proved to be a costly mistake with me.  I
ultimately chose the Animas pump based on the helpfulness of the sales staff,
the pump's  size, the use of standard luer-lock infusion set compatibility,
the pump's reservoir capacity and the ease of programming the Animas pump.

I then contacted Animas and let them negotiate directly with my insurance
company.  Shortly thereafter, they were also able to negotiate a deal for
insurance coverage, and I had my Animas pump which was 100% paid for.  The
sticking point with my insurance company was the ultimately the ability to
trade the pump in for a new one when the warranty expires -- usually 4 years. 
If I'd had a different insurance company, it might not have worked the same
way, so I think that insurance coverage is the major factor in the U.S., but
the patient may also be a major factor.

Scott Strumello

Dx'd Type 1 9/1976 at age 7; pumping with Animas R1000 since 6/2002 at age 33

Date: Tue, 12 Aug 2003 13:38:50 +0200
From: Nicolas Eisen <email @ redacted>
Subject: [IP] Re: How does it work in your contry?

I was wondering how do you choose and buy a pump where ever you live?
Here, in France, you can try them before you buy them, for example
I hesitate between the cozmo and the anima so two weeks of one and two 
of the other and then, as an informed customer, I can make my choice.

- -- 

Nicolas Eisen

email @ redacted
phone +33 5 49 49 68 79
fax   +33 5 49 49 69 01

Universiti de Poitiers  UFR Sciences SP2MI                   
Dipartement de Mathimatiques                    
Tiliport 2  Boulevard Marie et Pierre Curie      
BP 30179 86962 Futuroscope Chasseneuil Cedex 
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