The U.S. could save $4 billion a year if more seniors with type 2 diabetes followed their doctor’s orders, according to a new report by the IMS Institute for Healthcare Informatics.
That equals nearly a third of everything Medicare spends annually on diabetes medications. The avoidable costs makes the United States a leader in wasted health care spending on type 2 diabetes, despite improved diagnosis and advances in treatment, according to the report by the New Jersey-based health analytics organization.
One of the reasons for the stubbornly high spending is that so few people stick with their treatment — largely because they can’t afford to, IMS Director Murray Aitken said.
Out-of- pocket expenses are too much for some of the seniors who were having trouble covering the cost of treatments, such as insulin.
Brazil in contrast did the best job of the six countries analyzed in the report of curbing unnecessary diabetes spending. Brazil, where 11.5 million people are living with type 2 diabetes, fully covers the cost of diabetes care, Aitken said.
The issue of cost coverage impacts compliance is something IMS will be looking at further, he said. “It’s a major problem,” he said. In addition to the U.S. and Brazil, the research looked at spending on type 2 diabetes in Germany, the Kingdom of Saudi Arabia, Mexico and the United Kingdom, where the disease weighs heavily on healthcare budgets.
“Every country is looking at and aware of type 2 diabetes,” Aitken said.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
Yet on average, less than 40 percent of type 2 diabetes patients globally are taking the prescribed dose of medicine for the recommended length of time, according to the report based on IMS data, as well as existing studies, and sponsored by Lilly Diabetes.
Complications accounted for an estimated 61 to 80 percent of type 2 diabetes-related costs in the countries studied, with 4 to 15 percent of costs linked to not taking complying correctly with treatments. Brazil for example is expected to see the number of people living with the condition double by 2040 despite its healthcare spending.
Although insurance costs were a driving force behind not staying on course with care, and thus unnecessary costs, Aitken said the answer isn’t quite so simple.
“It’s never one thing,” he said. Looking at the report, it is a combination of the personal and the political. That makes sense because type 2, the most common form of diabetes, develops over time. It prevents the pancreas from using insulin properly. Glucose builds up in the blood instead of going to the cells. Getting treatment and following recommended lifestyle changes can prevent or delay the onset of complications like kidney damage, heart failure and blindness, according to the American Diabetes Association.
IMS identified five major drivers that impact how well people followed their diabetes care: health beliefs and attitude; personal circumstances; health status; health literacy; and access and affordability. That breaks down generally into things like age, gender, social network and socio-economic factors. Do they have access to affordable, safe healthcare, fresh food and exercise?
But the research avoided addressing them specifically.
Photo: Flickr user Bodytel
