High co-payments hinder diabetes treatment

Actively managing diabetes is essential to prevent long-term health complications, but rising costs are a barrier to treatment.

According to the Centers for Disease Control and Prevention, diabetes is now the most costly chronic disease in the United States. The total cost of diabetes in 2022 will exceed $400 billion, accounting for one-quarter of all health care spending in the United States.

According to a Michigan Medicine study published in Diabetes research and clinical practice, People with diabetes, especially those with type 1 diabetes, face high out-of-pocket costs. compared to people without diabetes.

The researchers used a national health insurance claims database to match subjects with similar demographics to ensure comparable populations with type 1 diabetes, type 2 diabetes, and those without diabetes.

Investigators tracked total costs and out-of-pocket expenses from 2009 to 2018, as well as medication costs, diabetes supplies, visits to health care providers, hospitalization costs, and emergency room visits.

The research team found that type 1 diabetes had the highest total costs and out-of-pocket costs in 2018, at $25,652 and $2,037, respectively.

Type 2 diabetes followed closely in both total costs and out-of-pocket costs, while those without diabetes paid significantly less, paying an average of $14,220 total and $1,122 out-of-pocket.

From 2009 to 2018, total costs increased for all three groups, but only patients with type 1 diabetes saw an increase in out-of-pocket costs.

“If the trends we have observed continue, people with type 1 diabetes will increasingly face unaffordable out-of-pocket costs,” said lead author and director of Michigan Medicine’s NeuroNetwork for Emerging Therapies. said statistician Dr. Evan Reynolds.

Rising drug prices are a major driver of this trend, accounting for the largest portion of out-of-pocket costs regardless of diabetes status.

Hypoglycemic drugs, especially insulin, have been steadily increasing in price for both type 1 and type 2 diabetes.

“Research shows that the higher a patient’s out-of-pocket costs, the less likely they are to stay on their medication for the long term, which poses serious health risks,” Reynolds said.

In addition to expensive medications, people with type 1 diabetes also face increased costs for diabetes management supplies such as syringes, pumps, and diabetes test strips.

“We’re concerned that patients are not getting any preventive health care services,” said lead authors Brian Callahan, MD, a neurologist at the University of Michigan Health, and Eva Professor of Neurology. said L. Feldman, MD. At UM School of Medicine.

“Diabetes prevention measures not only have health benefits, but they can also save you money in the long run.”

Researchers say the out-of-pocket costs for these treatments can be a significant burden for patients, leading to financial losses.

“Economic toxicity is when health care costs begin to negatively impact every aspect of a patient’s life, impacting both physical and mental health,” Reynolds said.

“Diabetes health care providers should be proactive in screening for the side effects of these costs and looking for signs of depression or anxiety.”

People living with type 1 diabetes are particularly at risk of economic toxicity. What is the first step to combat this? Reynolds says it could reduce the cost of blood sugar-lowering drugs.

“We need to enact policies that reduce or stabilize out-of-pocket costs and encourage people to properly treat their diabetes,” he said.

“Reducing the price of insulin is an urgent need at this time, as pharmaceuticals are at the top in terms of cost and usage.”