Annual U.S. spending on diabetes drugs nearly doubled in only six years, from $6.7 billion in 2001 to $12.5 billion, driven by an increase in patients, growing reliance on multiple drugs and a shift toward more expensive new medicines, a new study shows.
The study, funded by public and private grants and conducted at the University of Chicago and Stanford University, looked at two databases to determine trends in the treatment of patients with Type 2 diabetes who visited physicians between 1994 and 2007, as well as information on the cost of diabetes medications from 2001 to 2007.
The results, published in the Oct. 27 issue of the Archives of Internal Medicine, show the number of Americans diagnosed with diabetes rose steadily from 10 million in 1994, to 14 million in 2000 and to 19 million in 2007.
By 2002, one-tenth of all U.S. health care expenditures were attributable to diabetes, the study’s authors noted, and this raises “important questions” about whether the growing cost of medications is actually leading to better care.
“The single greatest contributor to increasing costs is the use of newer, more expensive medications,” said lead author Dr. Caleb Alexander, assistant professor of medicine at the University of Chicago. “But new drugs don’t automatically lead to better outcomes.”
The study found one indicator of benefit from diabetes drugs, average levels of the hemoglobin A1c blood test, improved between 1999 and 2004. But Alexander noted that hemoglobin A1c levels, which reflect the three-month average of blood sugar, “may not always correlate with long-term outcomes that people really care about, such as diabetes’ impact on heart and kidney function.”
The study found the number of drugs taken by each patient has increased from an average of 1.06 in 1994 to 1.45 in 2007. In 1994, 82 percent of patients were prescribed only one drug; in 2007, only 47 percent were.
Meanwhile, the average price of a diabetes drug prescription increased from $56 in 2001 to $76 in 2007, the study found, due in large part to the rapid uptake of newly available oral medications, increasingly prescribed as alternatives to injectable insulin. •
