- The cost of covering a person with diabetes has jump sharply higher this decade, while drug utilization only rose modestly, according to a new report by the Health Care Cost Institute, a nonprofit research group.
- Average costs for managing Type 1 diabetes through employer-sponsored health insurance plans totaled almost $18,500 in 2016, up from just under $12,500 in 2012. The group said 47% of that increase is attributable to higher spending on insulin.
- On a per-person basis, annual spending for insulin increased from roughly $2,900 in 2012 to just over $5,700 in 2016 — a jump driven primarily by price hikes and, less significantly, a shift toward more expensive products. The analysis did not look at rebate data or analyze patient out-of-pocket costs.
Diabetes is a major health cost driver, and the disease's prevalence is only expected to increase as 86 million Americans adults are estimated to have prediabetes.
The American Diabetes Association has said costs associated with treating the more than 30 million people with diabetes in the U.S. are more than double those without diabetes. The group estimates that diagnosed diabetes costs the U.S. $327 billion annually.
As the cost of insulin products rise, patients can be faced with difficult choices to ensure access to the needed medicine. Forgoing or rationing insulin, reports of which have appeared more frequently in recent years, carries severe health risk.
In the HCCI study, researchers looked at health insurance claims from between 13,800 and 16,200 people with Type 1 diabetes covered through employer-sponsored plans. The Type 1 version of the disease affects about 1.5 million Americans.
Every insulin product included in HCCI's report with price data over the five years studied increased in cost. The median price across the studied medicines increased by 92% between 2012 and 2016, according to the report.
Insulin cost growth also exceeded that for other costs, including non-insulin prescriptions, inpatient and outpatient care.
The authors said the findings are consistent with anecdotes of patients not being able to afford insulin. Niall Brennan, CEO of HCCI, said it's difficult to square the increases with the fact that the drug hasn't changed significantly.
"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 in a statement.
The research found that shortages or increased need weren't to blame for the price increase. HCCI said insulin use went up just 3% over the period.
Insulin delivery methods are changing, though. Syringes remain the most common vehicle for delivery, but prefilled insulin pens have become much more prevalent, accounting for 46% of usage in 2016.