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Cost of Having Diabetes Has Doubled in Two Decades

More than half of additional spending is for medications, study finds

The cost of managing diabetes has more than doubled in the past 20 years, according to a new report from Reuters. The average diabetes patient now spends $2,790 more per year than he or she did in 1987 –– and more than half of the additional spending is for medications.

The new findings were published in Diabetes Care.

“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 Dr. Xiao-hui Zhou, a health economist at the Centers for Disease Control and Prevention (CDC) who led the study.

Zhou and his 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 health care than did people without diabetes. In 2000 and 2010, with more people responding (approximately 39,000 each time), the extra spending by diabetics rose to $4,205 and $5,378, respectively.

When the researchers accounted for factors such as age, race, obesity, and the type of care, 55% of spending by diabetic patients was on prescription medications; 24% was for inpatient visits; 15% was for outpatient visits; and 6% went toward emergency room (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 was: both. Diabetes patients now use more medications, 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, according to the authors.

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 told Reuters Health.

Tim Dall, a managing director with IHS Life Sciences who studies the economic side of diabetes care but was not involved in the new 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 that “patients now receive a more complicated treatment regimen than in the past.” Some newer drugs are eight to 10 times more expensive than older drugs, such as sulfonylureas, Zhou said.

Dall feels that while costs may be high, 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.

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.

Sources: Reuters; February 2, 2015; and Diabetes Care; January 15, 2015.

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