Breaking down diabetes
In the last 20 years, the number of adults diagnosed with diabetes has more than doubled.
In the last 20 years, the number of adults diagnosed with diabetes has more than doubled.
Diabetes mellitus refers to several conditions where the body does not produce appropriate levels of insulin (measured as A1C scores over a three-month period), a hormone that unlocks cells to allow glucose, or blood sugar, to enter. Diabetics either don’t create enough insulin, or their cells don’t respond properly to insulin.
A person is considered prediabetic if he or she has higher blood glucose (blood sugar) levels that are higher than normal, but not high enough to justify a diagnosis of diabetes
Also known as insulin-dependent diabetes, it is an auto-immune condition that attacks the pancreas affecting the ability to create insulin. Formerly called juvenile onset diabetes.
The most common form of diabetes. In which a diabetic’s body either doesn’t produce enough insulin or becomes resistant to insulin. It is a largely preventable progressive disease influenced by risk factors such as smoking, obesity, physical inactivity, high blood pressure and poor diet.
Diabetes that is diagnosed for the first time during pregnancy (gestation) and is believed to be triggered by hormonal changes. It is a temporary condition, although it does raise the risk of eventually developing Type 2 diabetes. The Center for Disease Control estimates that it occurs in 2 to10% of pregnancies.
The total estimated cost of diagnosed diabetes in 2017 in the U.S. was $327 billion, according to the National Diabetes Statistics Report 2020. This total reflects $237 billion in direct medical costs and an additional $90 billion in reduced productivity (absenteeism and reduced productivity at work for those in the labor force, inability to work, and premature deaths attributed to diabetes).
The American Diabetes Association (ADA) estimates that economic costs of diabetes, adjusted for inflation, increased by 26% from 2012 to 2017. This is due to both an increased prevalence of diabetes and the increased cost per person. The growth in diabetes prevalence and medical costs is primarily among the population aged 65 years and older, raising economic cost of the Medicare program.
| Direct | Indirect | Total | |
| 2012 | $188 billion | $73 billion | $260 billion |
| 2017 | $237 billion | $90 billion | $327 billion |
People with diagnosed diabetes incur average medical expenditures of approximately $16,750 per year, of which roughly $9,600 is directly attributed to diabetes. People with diagnosed diabetes have, on average, medical expenditures of 2.3 times higher than people who do not have diabetes.
Diabetes is an ideal target for prevention strategies as it is a major risk factor for other serious chronic conditions and can be managed through a combination of lifestyle changes and health care interventions such as prescription medications including insulin. The high prevalence of diabetes means that prescriptions for diabetes medications are very common.
As an experienced Pharmacy Benefits Manager (PBM), IPM is well-equipped to help clients and members deal with the rising cost of diabetes and diabetes medications.
Health and Economic Costs of Chronic Diseases