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Chronic Disease Management, Diabetes Patient Costs Up $6K

Chronic disease management costs for patients with type 1 diabetes increased from $12,500 to $18,500 between 2012 and 2016.

chronic disease management cost

Source: Thinkstock

By Sara Heath

- Chronic disease management and treatment for individuals with type 1 diabetes can cost patients thousands of dollars each year, primarily due to the increasing cost of insulin, according to a recent report from the Health Care Cost Institute (HCCI).

The report, which looked at claims data for between 13,00 and 16,000 patients with type 1 diabetes who are enrolled in employer-sponsored healthcare plans, revealed that the high cost of medication is the biggest source of high overall costs.

“Our findings are consistent with the flurry of new reports telling stories about individuals being unable to afford their insulin,” said Jean Fuglesten Biniek, PhD, the report’s lead author. “Every single insulin product got substantially more expensive over just five years.”

The cost of managing type 1 diabetes rose from $12,500 to $18,500 during the study’s period of 2012 to 2016, the report noted. Forty-seven percent of that $6,000 price hike can be attributed to rising insulin costs.

Insulin spending totaled at $5,700 per person in 2016, up from $2,900 in 2012. That 2016 figure represents one-third of total healthcare spending for individuals with type 1 diabetes.

Further, every type of insulin increased in cost during the study period. Although there is no generic version of insulin, there are numerous variations based on when and how the patient takes the drug. Most patients use a combination of insulin types based on their specific disease needs.

Between 2012 and 2016, every brand of insulin saw price hikes. The average cost increase during this time period was 92 percent, or nearly doubling costs, the authors stated.

Of course, it is possible that diabetes care management spending increased because patients were using more insulin. When more of a medication is purchased and consumed, prices inevitably soar.

But that is not the case here, the authors revealed. Insulin use only increased by 3 percent during the study period, suggesting that the cost of the drugs themselves are the problem, not the pace at which they are administered and used.

There were some changes in which types of insulin patients used, the authors acknowledged. Patients chose different insulin delivery methods, with more patients opting for the pre-filled insulin pens than in previous years.

Thirty-eight percent of patients with diabetes selected pre-filled insulin pens in 2012, compared to 46 percent who made the same choice in 2016.

Conversely, the number of patients selecting vial-and-syringe insulin delivery methods decreased during the study period, although it does remain the most popular method for patients with diabetes.

In 2012, 61 percent of patients chose insulin in a vial. By 2016, that number decreased to 53 percent of patients.

These price hikes impacted patients’ out-of-pocket costs, the report continued. For a patient using the typical insulin type at a typical rate, prices increased about 92 percent between 2012 and 2016, or from $3,200 to $5,900 annually.

As suggested by the HCCI author, these findings represent serious issues for the 1.5 million patients with diabetes, or any chronic illness for that matter. As the drugs necessary to maintain wellness continue to rise, patients will struggle to access these drugs, potentially putting their health at risk.

“There has been a flurry of news reports sharing stories of individuals with diabetes rationing their insulin because they cannot afford higher and higher prices,” the report authors noted. “These anecdotes are consistent with findings of researchers documenting price increases on diabetic therapies, specifically insulin, over the last several years.”

What’s more, these high drug costs are not even coming with the benefit of medical innovation, said HCCI CEO Niall Brennan.

 “We are frequently told that high drug prices are justifiable in order to promote innovative new cures, but the cost of insulin – a longstanding therapy that 1.25 million Americans with type 1 diabetes rely on to live – has nearly doubled in the last five years, despite very little change in the underlying product,” Brennan said.

Price increases pose a considerable threat to patient care access. As noted above, patients often ration out their supply of certain medications critical for chronic disease management. As time wears on, this could harm patient health, ultimately putting a bigger strain on national healthcare spending.

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