Diabetes spending has increased, mostly due to prescription costs

Managing diabetes has become more expensive in the past 20 years, mostly due to more spending on drugs, a study found, while a second paper suggested that older patients are more likely to be using medications to control their condition.

In the first study, researchers calculated the change in medical spending and utilization related to diabetes using the National Medical Expenditure Survey for the year 1987 and the Medical Expenditure Panel Surveys for the years 2000-2001 and 2010-2011, with results published by Diabetes Care on Jan. 15.

Excess medical spending attributed to diabetes was $2,588 per person (95% CI, $2,265 to $3,104) in 1987, $4,205 (95% CI, $3,746 to $4,920) in 2000-2001, and $5,378 (95% CI, $5,129 to $5,688) in 2010-2011 (P<0.001). Of the $2,790 increase between the first period and the last, prescription medication accounted for $1,528 (55% of the increase), inpatient visits accounted for $680 (24%), and outpatient visits accounted for $430 (15%). ED visits and other medical spending accounted for 6%.

The prescription spending increase was due to the growth in both diabetes drug use and prices, the authors found. The increase in outpatient expenditure was almost entirely driven by more outpatient visits. The increase in inpatient and ED expenditures was caused by the rise in unit cost, the authors concluded, because the number of hospital admissions, the nights of hospital stay, and ED visits decreased modestly or remained unchanged.

By comparison, from 1999 to 2011, national data suggest that growth in the use and price of prescription medications in the general population was 2.6% and 3.6% per year, respectively, and the growth has slowed in recent years, the researchers wrote.

“Our analysis suggests that the growth rates in the use and prices of prescription medications for diabetes patients are considerably higher,” they wrote. “The higher rate of growth is likely, in part, due to the growing emphasis on achieving glycemic targets, the use of newer medications, and the use of multidrug treatment strategies in modern diabetes care practice.”

Another study provided a snapshot of how age affected utilization of diabetes care. A National Center for Health Statistics Data Brief found that the percentage of adults with diagnosed diabetes who were taking any medication to control their glucose levels increased with age, with 28.8% of younger adults (ages 18 to 39) not taking any medication to control their diabetes compared with only 13.5% of adults ages 65 who were not taking any medication to control their diabetes. The percentage of adults with diagnosed diabetes who had contact with an eye or foot care specialist in the past 12 months also increased with age, and those ages 18 to 39 were the least likely to have had their blood pressure or blood cholesterol checked during the past 12 months.