One in Four Patients Concerned About Diabetes Drug Costs

Marlene Busko

August 21, 2019

Roughly one in four adults with diabetes asked their physician for a cheaper prescription drug and 13% of patients took less medicine than prescribed to try to lower their drug costs, according to recent survey data.

The findings are from an analysis of data from the 2017-2018 National Health Interview Survey by Robin A. Cohen, PhD, and Amy E. Cha, PhD, MPH, National Center for Health Statistics, Centers for Disease Control and Prevention (CDC), which was published online on August 21.

Unfortunately, the survey data did not specify how many patients had type 1 or type 2 diabetes, which medications they had been prescribed, or which medications they cut back on (which could have been nondiabetes medications). 

And importantly, given the spiraling insulin costs that are becoming onerous, the report does not state how many of these patients had been prescribed insulin.

Nevertheless, the data brief provides a glimpse into the use of two strategies to save money for prescriptions, broken down by gender, age, and insurance coverage.

Risky Strategies to Cut Out-of-Pocket Drug Costs

Individuals in this nationally representative survey had reported that a physician had diagnosed them with diabetes and prescribed medication.

Participants were asked whether, in the past year, they had asked their physician for a lower-cost medication and either skipped medication doses, taken less medicine, or delayed refilling a prescription to save money (which researchers classified as "not taking their medication as prescribed").

Men and women were equally likely to ask their physician for a lower-cost medication (23.4% and 25.5%, respectively).

Women, however, were somewhat more likely than men to not take their medication as prescribed (14.9% vs 11.6%; P <  .05).

Notably, nonsenior adults (aged 18-64 years) were much more likely than seniors to not take medication as prescribed (17.9% vs 7.2%; P <  .05).

Adults younger than 65 years were also somewhat more likely than adults aged 65 years and older to ask their physician for a lower-cost medication (26.3% vs 21.9%; P < .05).

Among adults younger than 65 years, use of these money-saving strategies differed based on insurance coverage.

That is, those who were uninsured were roughly twice as likely as those with Medicaid or private health insurance to not take their medication as prescribed (37.5% vs 17.8% and 35.7% vs 14.0%, respectively; P > .05).

And uninsuredindividuals were almost twice as likely as those with private health insurance to ask a physician for a lower-cost medication (42.6% vs 25.7%; P < .05).

Those with Medicaid coverage were least likely to ask for a lower-cost medication (25.7% vs 18.8%; P < .05).

Among adults aged 65 years and older, the percentage who did not take their medication as prescribed did not differ significantly by insurance coverage: private insurance (6.2%), Medicare and Medicaid (6.2%), Medicare Advantage (9.3%), or Medicare only (9.2%).

In this older age group, about a quarter of those with private insurance (26.1%), Medicare Advantage (25.8%), or Medicare only (22.7%) coverage reported asking their physician for a lower-cost medication, but only 13.0% of patients covered by Medicare and Medicaid did so (P < .05).

To put this in perspective, the authors note that in 2017 the annual per capita expense for outpatient medications for individuals with diagnosed diabetes was almost $5000.  

And in 2018, there were 214 million prescriptions for diabetes medications (which was sixth out of the top 20 therapeutic classes of dispensed prescriptions).

"Recently, there has been a shift towards lower-cost options as the first line of therapy for diabetes management," they conclude. "However, the burden associated with high prescription drug costs remains a public health concern for adults with diagnosed diabetes."

The research was funded by the CDC.

NCHS Data Brief No. 349, August, 2019. Full text

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