I’m two months into cortisol pumping and have only recently found out all of my out of pocket costs – clearly not ideal informed consent. This has been partly due to misinformation (“you’ll need to pay for everything yourself” misadvised one doctor), partly due to uncertainty of funding (e.g. the final insurance approval occurred two months after receipt of my pump), and partly because I was a trail-blazing guinea-pig (see picture above).
Although your costs may differ from mine depending on your individual circumstances and preferences for bumbags with dragon scales, I hope this information is better than the nothing that I started with.
I discuss alternative avenues for funding/purchase here under the pump-objection “it will be expensive for you”.
Note that I’m based in Australia. All costs are provided in Australian dollars, and are based on available rebates in Australia.
Pump – $0
My private health insurer paid for my Medtronic Mini-Med 670G pump. Yep, the whole $9k. Whoop-whoop.
Quick-Serter – $56
The Paradigm Quick-Set infusion sets I’m currently using don’t have a built-in automatic shoot-the-needle-into-your-skin-thingy. Instead, you need to buy this separate reusable device. I like that it reduces plastic waste.
Pump Bands – $250ish
I’ve been like Goldilocks, trying different pump holding solutions and finding that some are too soft (they are great for sleeping but stretch too much and the pump falls out) and some are too hard (they are size adjustable but have hard plastic buckles and can be difficult to wash):
- 4 lycra waist bands – $30 each. See: https://www.diabete-ezy.com/insulin-pump-accessories
- A “Spi belt” with an extended sized pouch – $35. See: https://www.injinjiperformanceshop.com.au
- A pair of Body Bands with window – $70. I just switched over to using these. Love that they are both adjustable and comfortable. See: http://www.hid-in.com/
- A hippie waist bag I bought at a market – $30. I also splurged on a leather festival/doof belt with little dragon scales. These two give my body a break from having a brick pressed against the skin 24/7, work better with some dresses and they look cool.
Pump Alert Sticker – $16
The blue text on my pump that reads “Solucortef Pump, Do Not Remove, Adrenal Insufficiency” is a sticker/skin. I designed it using the custom option on this US website, I could input my pump model and they made it to fit: https://pumppeelz.com/
Medical ID Band – $43
I updated my existing medical ID bracelet to include the line “wears pump for cortisol”. I get mine from US website Road ID: https://www.roadid.com/
Healthcare Costs – $1000+
- Two appointments with an endocrinologist for the pump-start – $100 (after Medicare rebate).
- Two appointments with a Diabetes Educator for the pump-start – $0 (using a Medicare GP Care Team Plan).
- Because I couldn’t find a local endo to support cortisol pumping: The travel costs of two interstate trips for myself and my partner/carer for testing, appointments and pump start – $? (no healthcare funding available).
- Private health insurance excess for admission to a private hospital for testing – $500.
- Pathology testing – $0 (bulkbilled by Medicare).
Consumables – $50 a month
Consumables are the infusion sets and reservoirs; the pump supplies that you change every few days. Medtronic have given me a grant that reduces the cost of these supplies from over $1000 for approximately 3 month’s supply to $150. Big yay.
Solu-Cortef – $40 a month
Solu-cortef (liquid hydrocortisone) on private prescription costs $68 for 6 bottles of 250mg act-o-vials. I claim back $28 per script via my private health extras insurance, making my out of pocket cost $40 for 6 bottles. Given that I now routinely change my reservoir every 5 days (instead of the 3 I started off doing), 1 script of 6 bottles neatly lasts me one month.
Injection Equipment – $12 per month
- Needles (23G and 25G) and syringes (3ml) – free from a local needle and syringe program.
- Sterile water – $0.50 per bottle from a local needle and syringe program.
- Sharps disposal bin – free from local Council.
- “Skin prep wipes” – $0.70 each. These clean my skin before insertion of the cannula, and create a film barrier on my skin that reduces reactions to the adhesive tape and improves adhesion. From: https://store.independenceaustralia.com/
Portable Contents Insurance – $200 per year
I wanted insurance coverage for my pump in case of accident or theft at home or whilst on holiday – I pictured dropping the pump in the floor or having my beach bag stolen with the pump inside. After a lot of digging around in fine print of different policies, I shifted our home and contents insurance to Allianz and listed the pump under specified portables cover.
Healthcare Costs- $?
- Because I couldn’t find a local endocrinologist to support cortisol pumping: Skype appointments with an interstate endocrinologist – $100 each (no Medicare rebate is available for non-rural telehealth patients). Plus future travel costs for trips to see my endocrinologist face-to-face – $? (no healthcare funding available).
- Appointments with my GP to treat dermatitis from the set’s adhesive tape and for ongoing solu-cortef scripts – $30 each visit (after Medicare rebate).
- Pathology testing – $0 (bulkbilled by Medicare).
Other Bits and Bobs
- Hand sanitizer
- Pump key (used in place of a coin to open the battery cover on the pump) – $10 from: https://www.insulinpumpangels.com/insulin-pump-keys/
- Antiseptic cream