Report: Better adherence cuts diabetes costs
- According to Express Scripts' latest diabetes spending report, improving adherence cut emergency room visits and potentially saved over $210 million in healthcare spending in 2016.
- Patients who remain adherent had 235 fewer ER visits and 50 fewer inpatient stays per 1,000 patients, and their total healthcare costs were nearly $500 less. Those with diabetes-related complications had costs that were 9.4% lower than those who weren't adherent.
- Those people who weren't adherent had medical costs that were 1.3 times higher and total healthcare costs that were 4% higher compared with adherent patients.
Diabetes is a chronic condition affecting huge numbers of people. Estimates from the Centers of Disease Control and Prevention, out last month, show that around 30 million people in the U.S. have been diagnosed with diabetes, and a further 84 million are at risk of developing type 2 diabetes. The healthcare costs are high.
According to the latest figures issued by the American Diabetes Association, the total costs of diagnosed diabetes patients were $245 billion in 2012, of which $176 billion were direct costs. This has increased from a total cost of $174 billion in 2007 – a 41% rise over five years.
One route to reducing the expense, and also improving patient quality of life, is increasing patient adherence to medication and to lifestyle changes. A new report from pharmacy benefit manager Express Scripts has shown how the diabetes costs pile up, but also how adherence benefits both patients and the health system. For employers, the medical expenses for diabetics were over $9,000 per head overall. Non-adherence led to ER costs of 1.5-fold more and hospitalization costs of 1.6-fold more than for the non-adherent patients.
Adherence is increasing, according to Express Scripts' data, with adherence levels for oral diabetes medications increasing 3.6% between 2014 and 2016. There were a number of different factors involved.
"In 2016, our research found medication adherence to oral diabetes medications was greatest among commercially insured people age 65 and older at nearly 75%, followed by people aged 45-64 at nearly 65%, yet there is still room for improvement. People aged 20-44 have the greatest opportunity to improve adherence, with just under half of that population being adherent to their oral diabetes medications," said the report.
The company also saw links between delivery channels and volumes and adherence; 81% of people who received a 90-day supply of oral diabetes medication through home delivery, and nearly 68% of people who received a 90-day supply at retail, were adherent, compared with below 50% who had a 30-day retail supply.
- Express Scripts Diabetes Dilemma: U.S. Trends in Diabetes Medication Use
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