Factors contributing to the rising national cost of glucose-lowering medicines for diabetes during 2005–2007 and 2015–2017
Diabetes Care, 2020•Am Diabetes Assoc
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 …
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 …
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 US dollars.
RESULTS
National spending on glucose-lowering medications increased by 40.6billion(240%),ofwhichinsulinandnoninsulinmedicationscontributed 28.6 billion (169%) and 12.0billion(71%),respectively.Forinsulin,theincreasewasmainlyassociatedwithhigherexpendituresfromanalogs(156%).Fornoninsulin,theincreasewasaneteffectofhighercostfornewermedications(+88%)anddecreasedcostforoldermedications(−34%).Mostoftheincreaseininsulinspendingcamefromtheincreaseincost-per-user.However,theincreaseinthenumberofuserscontributedmorethancost-per-userintheriseofmostnoninsulingroups.CONCLUSIONSTheincreaseinnationalspendingonglucose-loweringmedicationsduringthepastdecadewasmostlyassociatedwiththeincreasedcostsforinsulin,analogsinparticular,andnewernoninsulinmedicines,andcost-per-userhadalargereffectthanthenumberofusers.Understandingthefactorscontributingtotheincreasehelpsidentifywaystocurbthegrowthincosts.
Am Diabetes Assoc
