Poland eyes expanded insulin pump coverage for adults with diabetes

Poland's Ministry of Health is considering significant changes to insulin pump reimbursement, aiming to extend coverage to patients with type 1 or type 3 diabetes who are over 26 years old. This proposed amendment to regulations on guaranteed benefits in outpatient specialist care could broaden access to insulin pump therapy for a previously excluded age group.

Under current rules, the National Health Fund (NFZ) finances insulin pump treatment only for patients up to the age of 26. These patients must also meet certain medical conditions, such as recurrent severe hypoglycemia, dawn phenomenon, significant glucose level instability, chronic diabetes complications, or ketoacidosis. The ministry has yet to specify the exact criteria older patients will need to fulfill or the timeline for implementing these changes.

This potential reform signifies a shift in the ministry's approach. Earlier in 2025, the Ministry of Health had informed the Commissioner for Human Rights that it did not plan to expand reimbursement. However, following further appeals from the Commissioner, the ministry commissioned the Agency for Health Technology Assessment and Tariffication to re-evaluate the necessity of the changes. The inclusion of this project in the legislative work agenda offers renewed hope that the age limit for insulin pump reimbursement may finally be lifted.