Factors Contributing to the Rising National Cost of Glucose-Lowering Medicines for Diabetes During 2005–2007 and 2015–2017
- 31 July 2020
- journal article
- research article
- Published by American Diabetes Association in Diabetes Care
- Vol. 43 (10), 2396-2402
- https://doi.org/10.2337/dc19-2273
Abstract
OBJECTIVE We examined changes in glucose-lowering medication spending and quantified the magnitude of factors that are contributing to these changes. RESEARCH DESIGN AND METHODS Using the Medical Expenditure Panel Survey, we estimated the change in spending on glucose-lowering medications during 2005–2007 and 2015–2017 among adults aged ≥18 years with diabetes. We decomposed the increase in total spending by medication groups: for insulin, by human and analog; and for noninsulin, by metformin, older, newer, and combination medications. For each group, we quantified the contributions by the number of users and cost-per-user. Costs were in 2017 U.S. dollars. RESULTS National spending on glucose-lowering medications increased by $40.6 billion (240%), of which insulin and noninsulin medications contributed $28.6 billion (169%) and $12.0 billion (71%), respectively. For insulin, the increase was mainly associated with higher expenditures from analogs (156%). For noninsulin, the increase was a net effect of higher cost for newer medications (+88%) and decreased cost for older medications (−34%). Most of the increase in insulin spending came from the increase in cost-per-user. However, the increase in the number of users contributed more than cost-per-user in the rise of most noninsulin groups. CONCLUSIONS The increase in national spending on glucose-lowering medications during the past decade was mostly associated with the increased costs for insulin, analogs in particular, and newer noninsulin medicines, and cost-per-user had a larger effect than the number of users. Understanding the factors contributing to the increase helps identify ways to curb the growth in costs.Keywords
This publication has 34 references indexed in Scilit:
- Evolution of insulin patents and market exclusivities in the USAThe Lancet Diabetes & Endocrinology, 2015
- Trends in Medicaid Reimbursements for Insulin From 1991 Through 2014JAMA Internal Medicine, 2015
- Use and Out-of-Pocket Costs of Insulin for Type 2 Diabetes Mellitus From 2000 Through 2010JAMA, 2014
- A Brief History of the Development of Diabetes MedicationsDiabetes Spectrum, 2014
- Decomposing Growth In Spending Finds Annual Cost Of Treatment Contributed Most To Spending Growth, 1980–2006Health Affairs, 2014
- Use of Antidiabetic Drugs in the U.S., 2003–2012Diabetes Care, 2014
- Treated Disease Prevalence And Spending Per Treated Case Drove Most Of The Growth In Health Care Spending In 1987–2009Health Affairs, 2013
- Health Care Expenditures for Adults With Multiple Treated Chronic Conditions: Estimates From the Medical Expenditure Panel Survey, 2009Preventing Chronic Disease, 2013
- Economic Costs of Diabetes in the U.S. in 2007Diabetes Care, 2008
- Physician Awareness of Drug Cost: A Systematic ReviewPLoS Medicine, 2007