As a UK-based, patient-led advocacy charity that exists to champion the rights of people with type 1 diabetes everywhere in the world, T1International is only too aware of how high drug prices and a lack of support services can negatively impact upon people living with chronic health conditions such as type 1 diabetes.

One such country where we advocate strongly defending the rights of patients is the USA. The free market healthcare model of the USA, which assumes that consumers have choice and that the market will set the price, is failing patients. Patients frequently do not have a choice about the medicine they need, and, as demonstrated all too clearly by out-of-control insulin prices - which have tripled over the past ten years - the 'free market' only works when competition is a factor and consumers can choose not to buy the product.

Pharmaceutical companies spend billions of dollars on lobbying for their interests and hold sway at the highest levels of government. Citizens rely on medical insurance tied to their employment, frequently afraid to change jobs for fear of losing some aspect of critical medical coverage. A study carried out in 2019 found that 66.5% of all personal bankruptcies in the USA were tied to medical issues. Patients are forced to pay high out-of-pocket costs for their medicine and we see people dying from rationing insulin, or suffering devastating and entirely preventable complications because they cannot reliably or affordably access their essential medicine or supplies. In a T1International study carried out in 2018, we found that 25% of American respondents had been forced to ration their insulin due to cost.

As the UK moves to the next phase of Brexit, we deeply hope that British citizens will reap the benefits to the NHS promised by those who campaigned to leave the EU. However, we also recognise that the UK is now in a vulnerable position as it moves forward to the negotiation of trade deals. Other countries will understandably seek to secure favourable terms for their own interests and regardless of current assurances, we have grave concerns at what might be 'on the table' as the negotiations take place.

The NHS has long been regarded as a jewel in the crown of the UK and the envy of many other countries. Healthcare free at the point of use and where the poorest as well as the richest are looked after should be something to celebrate and fiercely defend.

We stand ready to hold the UK government to account on the provision of healthcare for UK citizens with type 1 diabetes over the coming months and years. We will strongly resist any erosion of the current provision of essential medicine and supplies, medical devices or support services for patients with type 1 diabetes in the UK.