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In Ontario, for those using the Assistive Devices Program, the full cost of 1 Insulin Pump is covered every 5 years. As of March 2020, the Insulin Pumps covered by ADP include those manufactured by Medtronic, Omnipod, Tandem Diabetes Care, and Ypsomed.

The manufacturer warranty of most pumps in Ontario is 4 years. To determine out of pocket costs for those NOT using the ADP program, the calculator above splits the estimated total cost of the pump over 4 years. For tubed insulin pump, the estimated total list price is $6500. For non-tubed pumps, the estimated total list price of the PDM is $6300.

The Ontario Drug Benefit Formulary is a list of drugs that Ontario will cover for those who qualify for various programs. See our blog about the coverage, here. In general, if you qualify for the Trillium Drug Program, the total amount you will pay for ODB covered items is the total of your deductible (4% of your household income.) If you spend less than your deductible or you have not applied for the Trillium Drug Program, you will pay full price for these items.

FAST ACTING INSULIN

Apidra Pens (1500 units) from DiabetesExpress.ca: $59.64

Apidra Vial (1000 units) from DiabetesExpress.ca: $31.49

Fiasp Vial (1000 units) from DiabetesExpress.ca: $35.99

Novorapid Vial (1000 units) from DiabetesExpress.ca: $35.99

Humalog Vial (1000 units) from DiabetesExpress.ca: $35.99

Fiasp Pens (1500 units) from DiabetesExpress.ca: $71.04

Humalog Pens (1500 units) from DiabetesExpress.ca: $68.94

Novrapid Pens (1500 units) from DiabetesExpress.ca: $75.24

LONG ACTING INSULIN

Lantus Pens (1500 units) from DiabetesExpress.ca: $112.99

Lantus Vial (1000 units) from DiabetesExpress.ca: $71.75

Levemir Pens (1500 units) from DiabetesExpress.ca: $133.49

Toujeo Pens 3-pack U100 (450 units) from DiabetesExpress.ca: $92.04

Toujeo Pens 5-pack U100 (750 units) from DiabetesExpress.ca: $153.38

Tresiba Pens U100 (5×300 units) from DiabetesExpress.ca: $126.37

INSULIN PUMP SITES/PODS
Medtronic Mio / Mio 30 Infusion Sets (box of 10) from Medtronic Store: $215.00

Omnipod Pods (box of 10) from DiabetesExpress.ca: $300

Tandem TruSteel Infusion Sets (box of 10) from DiabetesExpress.ca: $195.00

Tandem Varisoft Infusion Sets (box of 10) from DiabetesExpress.ca: $195.00

Medtronic Quick-set Infusion Sets (box of 10) from Medtronic Store: $205

Medtronic Silhouette Infusion Sets (box of 10) from Medtronic Store: $205

Medtronic Sure-T Infusion Sets (box of 10) from the Medtronic Store: $168

Tandem Autosoft 90 Infusion Sets (box of 10) from DiabetesExpress.ca: $205

Tandem T:Lock Autosoft Infusion Sets (box of 10) from DiabetesExpress.ca: $205

YpsoPump Orbit Infusion Sets (box of 10) from Ypsomed (unlisted): $195 (Unlisted)

YpsoPump Orbit Micro Infusion Sets (box of 10) from Ypsomed (unlisted): $185 (Unlisted)

INSULIN PUMP RESERVOIR/CARTRIDGES

Medtronic Reservoirs (box of 10) from DiabetesExpress.ca: $43.50

Tandem Luer Lock / T:Lock Cartridge (box of 10) from DiabetesExpress.ca: $55.00

YpsoPump Reservoir (10 per box) (unlisted): $42.00 (Unlisted)

FLASH GLUCOSE MONITORING

FreeStyle Libre Sensor (1) from DiabetesExpress.ca: $99.00

CONTINUOUS GLUCOSE MONITORING

Medtronic Guardian Sensor 3 (5 pack) from Medtronic’s Online Store: $399

Dexcom Sensor (1) from Dexcom.com: $100.00 (10 days) + Transmitter (1): $289 (3 months)

Dexcom Yearly Subscription (12 boxes of sensors & 4 transmitters): $299/month

BLOOD GLUCOSE MONITORING

Contour Next Test Strips (100 strips) from DiabetesExpress.ca: $78.98

OneTouch Verio Test Strips (100 strips) from DiabetesExpress.ca: $84.98

FreeStyle Precision Test Strips (100 test strips) from DiabetesExpress.ca: $84.99

MULTIPLE DAILY INJECTIONS

BD Syringes (100 syringes) from DiabetesExpress.ca: $37.32 (BD)

BD Ultrafine Pen Needles (4mm – 100 caps) from Diabetes Express: 39.99

OTHER NON-FORMULARY ITEMS

Bayer Lancets (500) from DiabetesExpress.ca: $7.98 ( 1 box per year)

Baqsimi Glucagon (1) from DiabetesExpress.ca: $152.73 (1 per year)

BD Alcohol Swabs (100) from DiabetesExpress.ca: $2.95 (1 box per year)

Dex4 Tabs (50) from DiabetesExpress.ca: $8.95 (4 bottles per year)

Skin Tac Wipes (50) from DiabetesExpress.com ($21.49/box) (2 boxes per year)

OTHER COMMON FORMULARY-COVERED ITEMS

Lilly Glucagon (1) from DiabetesExpress.ca: $110.23 ( 1 per year)

Novo Glucagen (1) from DiabetesExpress.ca: $100.21 ( 1 per year)

Not sure about that math? Here’s how we got to that conclusion.

Total Estimated Yearly Trillium Deductible = Total Household Income x .04

Total Estimated Quarterly Trillium Deductible = Total Estimated Yearly Trillium Deductible / 4

Yearly cost of insulin = (# of fast acting units/day x cost/unit of fast acting insulin x 365) + (# of long acting units/day x cost/unit of long acting insulin x 365)

Yearly cost of insulin pump supplies = (daily cost of Insulin Pump Sites/Pods x 365) + (daily cost of Insulin Pump Reservoir/Cartridges x 365) + (total cost of insulin pump / 4 years warranty)

Yearly cost of glucose monitoring supplies = (# of times per day you check BGs x individual cost of BG test stips x 365) + (daily cost of CGM supplies x 365) + (daily cost of Flash Glucose supplies x 365)

Yearly cost of multiple daily injection supplies = (# of times per day you inject insulin x individual cost of syringes/pen caps x 365)

Estimated total yearly cost of diabetes supplies = (Yearly cost of multiple daily injection supplies + Yearly cost of glucose monitoring supplies + Yearly cost of insulin pump supplies + Yearly cost of insulin)

Estimated yearly out of pocket costs of insulin pump supplies =

If you answered YES to Are you currently using the Assistive Devices Program (ADP)? THEN

= Yearly cost of insulin pump supplies – $2400 – cost of insulin pump

If you answered NO to Are you currently using the Assistive Devices Program (ADP)? THEN

= Yearly cost of insulin pump supplies

Estimated yearly total of supplies covered for those on Trillium* = Yearly cost of insulin + (daily cost of Flash Glucose supplies x 365) + (# of times per day you check BGs x individual cost of BG test stips x 365) + Total of other common formulary covered items

Estimated total yearly cost of supplies included on the Ontario Drug Benefit formulary

If your Estimated yearly total of supplies covered for those on Trillium* is greater than your Total Estimated Yearly Deductible AND you answered YES to Are you currently registered for the Ontario Trillium Program? THEN

= Total Estimated Yearly Deductible

If your Estimated yearly total of supplies covered for those on Trillium* is LESS THAN than your Total Estimated Yearly Deductible OR you answered NO to Are you currently registered for the Ontario Trillium Program? THEN

= Estimated yearly total of supplies covered for those on Trillium*

Estimated total yearly spend on diabetes supplies = Estimated total yearly cost of supplies included on the Ontario Drug Benefit formulary + Estimated yearly out of pocket costs of insulin pump supplies + (Daily cost of Continuous Glucose Monitoring supplies x 365) + (Daily cost of Flash Glucose Monitoring supplies x 365) + Total cost of other non-formulary items + (# of times per day you inject insulin x individual cost of syringes/pen caps x 365)