How Much Members Spend on Diabetes Chronic Disease Management
It is well known that diabetes is a costly disease, but even members with insurance may pay thousands of dollars per year for chronic disease management.
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- Members with diabetes spend between $3,300 and $4,600 per year in out-of-pocket costs for chronic disease management, including lost wages, according to a new report from GoodRx Health.
These out-of-pocket cost estimates accounted for health insurance coverage but still represented 6 to 8 percent of the typical yearly wage in the US.
The researchers addressed the cost of managing diabetes separately from the cost of complications. They used data from the Medical Expenditure Panel Survey (MEPS) for 2021 and prices across online diabetes medical device suppliers to assess healthcare spending among patients with diabetes.
The cost of chronic disease management for members with diabetes may differ based on the type of diabetes and the types of medications members use. Provider visits, over-the-counter supplies, medications, and lost wages all contributed to diabetes costs.
Members with diabetes who had the lowest out-of-pocket costs on average were Type 2 diabetes patients without GLP-1 agonists or SGLT2 inhibitors—two medications related to diabetes treatment. These patients paid $3,372 out-of-pocket on average. In contrast, members with type 2 diabetes who used insulin with GLP-1 agonists or SGLT2 inhibitors paid the most, spending $4,616 on average.
For all five circumstances that the study analyzed (ranging from Type 1 diabetes patients taking only insulin to Type 2 diabetes patients with GLP-1 agonists/SGLT2 inhibitors), over-the-counter medical supplies contributed the most to costs, followed by lost wages.
On the higher end, over-the-counter supplies for monitoring blood sugar can amount to $2,700 each year, regardless of an individual’s coverage.
This cost includes one glucose monitor, 70 test strips per week, 70 lancets per week, one lancing device, and two bottles of control solution. The prices for all these items amount to approximately $2,712 per year.
“With insurance, medical supplies may be cheaper, but they may be less convenient to access since a prescription is required to use insurance. Patients may also have less flexibility on the brands and quantity they can get with insurance, depending on their plan,” the researchers noted.
Wage losses followed over-the-counter products as the second-highest cost associated with diabetes management across all of the diabetes types and treatment approaches. For patients with type 2 who took Insulin with GLP-1 agonists / SGLT2 inhibitors, yearly wage losses could amount to $1,163. On the lower end, individuals with type 2 diabetes who did not take insulin or GLP-1 agonists / SGLT2 inhibitors lost $472 per year on average.
These estimates reflected the impacts of absenteeism on workers with diabetes. On average, individuals with diabetes missed 5.5 days of work each year. They may also lose their employer-sponsored healthcare coverage as a result of their absenteeism.
All told, the out-of-pocket spending associated with diabetes management—on top of potential complications, both with diabetes specifically and comorbidities more broadly—can take a heavy toll on patients financially, even if they have health insurance coverage to shield them from the full brunt of the healthcare costs.
“More than 37 million Americans have diabetes, and more than 7 million of those people treat their condition using insulin. These out-of-pocket costs are a significant burden for them, on top of the hardships of monitoring their disease, checking blood glucose (sugar) levels, and injecting insulin regularly,” the researchers explained.
