It was the week before Christmas and Rhonda Watkins was desperate.
She needed to make a choice: buy life-saving insulin or the ostomy supplies to keep her body functioning.
Instead, Watkins went to the back of the fridge in her home in Conception Bay South, N.L., and grabbed an old box of expired insulin.
"You're kinda playing Russian roulette. You really don't know [what could happen] but you know you have to have insulin so you have to take that chance," said Watkins, 53.
"It's different than having an outdated bag of chips or something but I had to have insulin and if it was outdated that's all I could do."
Watkins had been relying on the Newfoundland and Labrador Prescription Drug Program, a publicly funded program administered by the Department of Health and Community Services, until her coverage was denied.
Without that coverage, she's using samples of insulin from pharmacies, has drained her savings, and is remortgaging her home — all to afford drugs and supplies she needs to survive.
Watkins is now calling on the provincial government to re-evaluate its drug coverage — a call echoed by a member of the provincial NDP who said he regularly fields calls from people struggling to pay for medication.
Meanwhile, the provincial government says its most recent budget includes measures to help alleviate the cost of living, and that a change in a person's financial situation can change the amount they receive through the drug plan.
In 2007, Watkins underwent surgeries for familial adenomatous polyposis, a genetic condition causing polyps to develop on the inside of the intestinal tract. That procedure resulted in Watkins having ostomy surgery, a procedure that allows bodily waste to be passed out of the body through a surgical opening.
A year later, Watkins, 40 years old at the time, was diagnosed with diabetes and became what she calls a "bad diabetic," taking four needles a day.
She was on disability leave from her career in the legal profession but was still accessing her employer's private health insurance, until the company changed hands. According to Watkins, the employees felt the premiums were too high, and they voted to opt out of the program, leaving her without health insurance.
Enter the prescription drug program, and Watkins breathed a sigh of relief. The provincial government covered 57 per cent of the medication expenses — ostomy supplies aren't among them, unless you're over the age of 65.
But that relief was short-lived.
"Every six months they review it and I was sent the notice in the mail that I wasn't eligible or I had to follow up, when I followed up the copay then was 93 per cent," Watkins said.
Watkins said she was told she wasn't spending as much money on medication, her child turned 18 and was no longer a dependent, and her husband made a couple thousand dollars extra on overtime.
"We've taken from our savings. I've maxed our credit cards. I've had to go inside my child's education fund," Watkins said, through tears.
"We are all suffering. It's stress from daylight to dark. It's planning. We have to do everything we can to scrimp and save."
Watkins requires rapid and long-acting insulin, and uses an insulin sensor.
If this is happening at 53, what's going to happen when I'm a senior? - Rhonda Watkins
Receipts provided by Watkins shows she has spent over $7,000 per year on drug costs, and nearly $4,000 per year on ostomy supplies.
Her household income is around $70,000, depending on how much overtime her partner works.
However, Watkins said she wasn't spending as much on medication simply because she couldn't afford it, and now without any coverage, she has been left at the mercy or doctors and pharmacists who try to provide insulin samples when they can.
The less she spends on medication, the lower her overall drug costs are — which will be to her disadvantage when she applies for future drug programs or tax credits.
Same old story
When the phone rings at Jim Dinn's constituency office, more often than not the person on the other end is struggling with drug coverage, he says.
"Oh my gosh, the people we encounter who are down to choosing rent, heat, food and sometimes taking drugs every third day to stretch it out," said Dinn, interim leader of the NDP.
"If it's policy, then change the policy, so it works for the people and not the bottom line and efficiencies."
Watkins said it's time that the plan be revisited to account for inflation and, high food and gas prices. The financial burden of her health problems on provincial government coffers would be reduced in the long run if she had access to medication now, she said.
"I always thought the province would help. We live in Canada.… I really lost everything. There was nothing, there is no hope. If my province couldn't help me, if I call an MHA and they couldn't help me, what else do I do?" Watkins said.
"If this is happening at 53 what's going to happen when I'm a senior? How many more people are going to experience this? It's not fair, it's really not fair."
Newfoundland and Labrador spends the most money per capita on health-care expenses but has the worst health outcomes. The population's life expectancy is 2.4 years lower in men and 2.3 years lower in women than the Canadian average — statistics that have steadily worsened since 1980.
Dinn said Watkins's predicament is an example of short-sighted policy that doesn't serve the population or provincial economy in the long run.
"If we're looking at the social determinants of health, we've got to look at the bigger picture," Dinn said.
"We are already paying for this, and we're going to end up paying more for it."
Dinn is calling on the provincial government to review policies with a person-first approach in mind, and extend the drug plan to include more recipients.
Cost of living
In a statement the Department of Health and Community Services said it could not discuss Watkin's case due to privacy reasons.
However, it said as a person's financial situations changes, so may their eligibility for the province's drug program.
Prescription drug coverage provided by the province's Assurance Plan, which Watkins had been covered under, is assessed every six months using the most recent income and drug cost data available.
A person's coverage and co-pay can also be impacted if they aren't filing their medications on a regular basis.
"We recognize this may be difficult for some people. Our government has taken steps in Budget 2022 to help ease the pressure associated with the cost of living," said a department spokesperson.
"We will continue to work to provide effective programs and services to support individuals, seniors, persons with disabilities and vulnerable populations."