Cost of diabetes

Cost of having diabetes has doubled in two decades 

Published February 02, 2015 

The cost of managing diabetes has more than doubled in the past 20 years, a new analysis says. The average diabetes patient now spends $2,790 more per year than they did in 1987 - and more than half the additional spending is for medications. 

 "People need to be mindful about the substantial increase in the cost of diabetes, which has been partially fueled by the rising prices of newer drugs," said Xiaohui Zhou, a health economist at the Centers for Disease Control and Prevention (CDC) who led the study. Zhou and colleagues compared National Medical Expenditure Survey data from 1987, 2000-2001 and 2010-2011. The 1987 survey, involving 22,538 people, showed that diabetics spent $2,588 per person more on healthcare than people without diabetes.

 In 2000 and 2010, with more people responding (roughly 39,000 each time), the extra spending by diabetics rose to $4,205 and $5,378, respectively. When the researchers accounted for factors like age, race, obesity and type of care, 55 percent of spending by diabetic patients was on prescription medication, 24 percent was for inpatient visits, 15 percent was for outpatient visits and 6 percent went toward ER visits and other expenses. The researchers also asked whether costs were higher because people used health services more, or because the price of the service had risen. The answer: both.

 Patients now use more medication, and the costs of the drugs have also risen. The increased cost of outpatient visits was mainly due to more visits, and inpatient and ER expenses grew as a result of rising prices, they write in the journal Diabetes Care. The U.S. is not alone in facing this issue. "A growing trend of increased spending on anti-diabetic prescription medications has also been observed in other developed countries," Zhou said in an email. Tim Dall, a managing director with IHS Life Sciences who studies the economic side of diabetes care but was not involved in this research, said the American Diabetes Association has previously found that "a large portion of diabetes-related costs are associated with the complications of diabetes rather than with treating diabetes itself. Zhou noted that new drugs and devices are constantly emerging and "patients now receive a more complicated treatment regimen than the past. 

Some newer drugs are eight to 10 times the cost of older drugs such as sulfonylureas, Zhou said. Dall feels that while costs may be great, the benefits of new developments are also substantial. "The average medical cost to treat people with diabetes has been increasing over time, but patients are getting better care and living longer," he told Reuters Health by email. However, he said, if a certain regimen is working well for a patient, there may not be a need to upgrade. 

Zhou and Dall say more effort needs to be put toward diabetes prevention and not merely management of the disease. "This growing trend of diabetes cost is simply unsustainable. Besides the efforts to bend the treatment cost, the efforts to reduce the number of future diabetes patients are imperative," Zhou said.