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Crossing between America and Canada is tougher these days due to the continuing COVID-19 pandemic, which means many Americans are cut off from an important source of affordable insulin.

For years, high insulin prices in this country have prompted many people with diabetes (PWDs) to cross borders in order to find more affordable insulin, mainly in Canada and Mexico. But that ground to a halt when those U.S. borders shut down for most of 2020.

One of those impacted is Heather Wood in southeast Michigan, who for several years before the COVID-19 crisis had been sourcing her insulin from Canada. She’s lived with adult-onset type 1 diabetes (T1D) since her late 30s in early 2017, and both her teenage son and her father live with this insulin-dependent type of diabetes too.

Being in Metro Detroit within a half-hour of the border, Wood says she had traveled to the nearest town of Windsor, Canada, for the past 5 years to find more affordable insulin. And then, COVID-19 hit.

“I absolutely panicked when I read about the border closings,” Wood told DiabetesMine.

Although bringing insulin back to the United States is technically illegal, it’s “decriminalized” by the Food and Drug Administration (FDA) and there’s a general policy exemption for individuals. That means for many years the authorities — in this case the FDA and Customs and Border Patrol — have allowed citizens reentering the country to bring limited amounts of medications needed for their personal use.

Wood was able to make it across the border a few more times even despite the pandemic-related closures, thanks to understanding border agents who determined it was an “essential” visit but instructed her to only travel to the Windsor pharmacy and then return.

Wood says she faced different scenarios each time, as the months progressed and COVID-19 restrictions evolved:

  • 1st visit: They allowed her in with a face mask as long as she didn’t go anywhere else.
  • 2nd visit: She entered Canada with her boyfriend but only one of them could enter the pharmacy while wearing a face mask.
  • 3rd visit: Wood again traveled to the border with her boyfriend, but she was forced to stay in the car at the Canadian customs’ side while he was allowed to walk to the local pharmacy to pick up the insulin prescriptions (just over a mile-and-a-half away). They were told to not return to Canada together anymore.
  • 4th visit: Wood’s boyfriend traveled alone, but U.S.-Canadian customs didn’t want to let him in unless he’d quarantine for 14 days in Ontario. After “frantic phone calls and talking to customs,” Wood says everyone agreed to allow the local Canadian pharmacist to deliver the insulin straight to her boyfriend at the border.

“My son currently has no way to obtain affordable insulin, and he was out the day my boyfriend tried to cross the border to pick up the insulin,” Wood said. “When he called and told me they weren’t letting him in, I broke down. Our only option would have been to take my son to the ER. And I wouldn’t have been able to afford the cost of the insulin anyway, let alone the hospital bill.”

Canadian Pharmacist Frank Vella

It was the generosity of pharmacist Frank Vella at Medica Pharmacy that changed everything that day, allowing Wood and her family to obtain needed insulin. Medica is a relatively new Windsor pharmacy opened by Vella himself in mid-2019. He spoke with DiabetesMine by phone and said it was the least he could do.

“When you become a pharmacist or doctor, you take an oath. I take that seriously, and try to do my part. When someone is having a problem, I try to run toward that problem and help if I can,” he said.

Vella says he has a special appreciation for the United States, as he attended pharmacy school at Wayne State University in Detroit and also did his residency at the Michigan-based St. John Hospital, before working for CVS and Rite Aid and later opening his own small pharmacy in Windsor. He says he’s happy to help now during this COVID-19 crisis because the United States was so welcoming to him earlier in life.

Vella said he has traveled to the border crossing more than once, to deliver not only insulin but other necessary prescriptions — ranging from cancer medications to a post-pregnancy meds — to Americans in need.

“We aren’t talking about narcotics or illegal drugs here, we’re talking seriously important things like insulin and cancer drugs,” he said. “People need these and if I can help, even by physically taking them through the border crossing to hand-deliver, I will.”

“Everyone’s trying to do their part and be understanding with what we’re dealing with,” he added.

For Wood and her family, that’s made all the difference in surviving with T1D when insulin and other supplies are so costly.

“The sheer relief of being able to get the insulin my son and I needed was incredible,” she said. “Knowing you require a medication to survive and not knowing if you will be able to acquire or afford it is something too many people struggle with.”

As a grassroots diabetes advocate who supports the #insulin4all movement, Wood says she has been involved in mutual aid efforts for the past few years and sometimes helps other PWDs get supplies and insulin they need. She got involved after struggling to afford insulin for her T1D son, who was diagnosed in March 2015 at age 12. Her father was also diagnosed a half-century ago in 1970 in his 20s, when he was fresh out of the U.S. Air Force.

So with that longtime T1D in the family, her own diagnosis at age 39 back in January 2017 wasn’t as much of a surprise as it might have been. Yet having multiple insulin-dependents in her household has made insulin affordability challenging.

Calculating her costs, Wood told DiabetesMine that without insurance their combined insulin needs would come to a whopping $2,286 price tag each month. By comparison, the Canadian cost is normally $734 per month.

With insurance, Wood and her dad generally get enough insulin, but it’s her son who has the most need for less-expensive Canadian insulin.

“I have had to ration at times when access was difficult, or when insurance or other difficulties made getting insulin harder than it needs to be,” she said.

“No one should ever have to ration their insulin. People are dying because of rationing. I am very lucky to live so close to the border to be able to access more affordable insulin. I wish everyone had this option. This is why I fight for #insulin4all. Almost every day there is a need for help, and it breaks my heart.”