Spending for people with diabetes is over $10,000 higher per capita than for those without

June 20, 2016 – In 2014, health care spending for people with diabetes covered by employer-sponsored insurance (ESI) grew at a much faster pace, rising nearly six percent compared to 3.2 percent for people without diabetes, according to a study released today by the Health Care Cost Institute (HCCI). Spending on people with diabetes reached $16,021 per capita in 2014, an $897 increase from the year before, and over $10,000 higher than per capita spending for people without diabetes. The rise in spending was partially due to an increase in the number of ER visits and use of prescriptions among people with diabetes which rose at an average annual rate of 8.1 percent and 8.7 percent respectively from 2012-2014.

The report, 2014 Diabetes Health Care Cost and Utilization Report, examines how much is spent on health care for adults and children with diabetes, where those dollars are spent, and how that compares to people without diabetes. It is based on the health care claims of more than 40 million Americans younger than 65 covered by ESI from 2012 to 2014. People diagnosed with type 1 or type 2 diabetes accounted for five percent of the ESI population in 2014.

“Understanding how and where we spend health care dollars for people with diabetes is the first step in assessing how well the health care system is working and where improvements can be made,” said HCCI Senior Researcher Amanda Frost.

While people with diabetes had twice as many doctor and ER visits and took over five times more prescription drugs than those without diabetes, they also used more services related to mental health and cardiovascular disease at higher rates:

  • People with diabetes had seven times more filled days of cardiovascular drugs. In 2014, there were 414,524 daily prescriptions for every 1,000 people with diabetes compared to just 55,291 for people without diabetes. Cardiovascular drugs—not insulin—were the most commonly used drugs among adults with diabetes (ages 26-64).
  • Young adults (ages 19-25) with diabetes had four times more hospital admissions for mental health and substance use than did young adults without diabetes. In 2014, there were 37 mental health and substance use per 1,000 young adults with diabetes – a 23.4 percent increase from the year before.

Each year of the study period, people with diabetes spent two and a half times more out of pocket than those without diabetes. In 2014, insureds with diabetes spent an average of $1,944 out of pocket per capita compared to $752 for those without diabetes. The difference in out-of-pocket spending between people with and without diabetes declined with age: there was a larger difference in out-of-pocket spending for children than for adults. In 2014, out-of-pocket spending per capita grew more slowly for people with diabetes–increasing by $10, compared to $19 for people without diabetes. Among those with diabetes, children had the highest out-of-pocket spending in 2014 ($2,173 per child), over a third of which was spent on prescriptions ($751 per child).

“This report examines the patterns of care for people with diabetes,” said HCCI Executive Director David Newman. “By looking beyond treatment for diabetes we can see what other health issues people with diabetes are facing – such as heart disease – so that the health care system might better address those complex needs.”

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