Quarter of U.S. diabetes patients report using at least one strategy to reduce drug costs

In a survey of U.S. adults with diabetes, about 13% who were prescribed medication said they did not take it as prescribed, and about 24% said they asked their doctors for a lower-cost medication.


Many adults with diabetes, particularly women and those younger than age 65, are using strategies to reduce their prescription drug costs, a recent study found.

Researchers used data from the 2017-2018 National Health Interview Survey to estimate the percentage of U.S. adults with diagnosed diabetes who reported attempting to cut prescription drug costs by not taking medication as prescribed (i.e., skipping medication doses, taking less medicine, or delaying prescription fills) and/or asking their doctor for a lower-cost medication. The nationally representative household survey was conducted continuously throughout the study year by the National Center for Health Statistics (NCHS). Results were published in the August 2019 NCHS Data Brief.

Overall, among adults with diagnosed diabetes who were prescribed medication in the past 12 months, 13.2% did not take their medication as prescribed due to cost, and 24.4% asked their doctor for a lower-cost medication. Women were more likely than men to not take their medication as prescribed (14.9% vs. 11.6%; P<0.05), but the percentage of women and men who asked their doctors for a lower-cost medication was not significantly different (25.5% vs. 23.4%, respectively).

A higher percentage of adults ages 18 to 64 years than those ages 65 years and older reported not taking their medication as prescribed (17.9% vs. 7.2%; P<0.05) and asking their doctors for a lower-cost medication (26.3% vs. 21.9%; P<0.05). For both age groups, use of these strategies to reduce prescription drug costs varied by health insurance coverage. Among adults younger than age 65 years, those who were uninsured were more likely than those with private insurance or Medicaid to not take their medication as prescribed (35.7% vs. 14.0% vs. 17.8%, respectively; P<0.05). Uninsured adults younger than age 65 years were also more likely than those with private insurance or Medicaid to ask their doctors for a lower-cost medication, and those with private insurance were more likely than those with Medicaid to use this strategy (42.6% vs. 25.7% vs. 18.8%, respectively; P<0.05 for both comparisons).

Among adults ages 65 years and older, the percentage of those who did not take their medication as prescribed did not vary significantly by health insurance coverage. However, adults ages 65 years and older with Medicare and Medicaid coverage were less likely than those with private coverage, Medicare Advantage, or Medicare only to ask their doctor for a lower-cost medication (13.0% vs. 26.1% vs. 25.8% vs. 22.7%, respectively; P<0.05).

For patients with diabetes, the annual per capita expense for outpatient medication was almost $5,000 in 2017, the study authors noted. “Recently, there has been a shift towards lower-cost options as the first line of therapy for diabetes management,” they wrote. “However, the burden associated with high prescription drug costs remains a public health concern for adults with diagnosed diabetes.”