Diabetes by the Numbers, and the Importance of Affordable Medication

Catching up on Yellowstone recently, I noticed a tribute to actor Wilford Brimley in the Season 3, Episode 9 credits. People of a certain age probably can’t think of Brimley without remembering his commercial spots for Liberty Medical.

“I’d like to talk to you for a few minutes about dia-beet-us,” they began. Brimley’s uncommon pronunciation remains the source of many memes decades later. They may be the only thing funny about this disease.

According to the CDC, more than one in 10 Americans has diabetes, mostly Type 2, and it’s the seventh-leading cause of death in the U.S. The financial toll is staggering: 25 cents of every healthcare dollar in this country are spent on diabetes care.

In recognition of American Diabetes Month, we’d “like to talk to you for a few minutes” on some lesser-known facts about this chronic condition. They all underscore the importance of medication adherence, and the positive impact RxSS can have on members with diabetes.

37.3M to 41.7M

The number of Americans with diabetes in 2019 and the projected number in 2030. This doesn’t count the 96 million aged 18 or older who have prediabetes, or 38% of the U.S. population.

2X+

People with diagnosed diabetes have more than twice the average medical costs that people without diabetes have.

Medication’s Share of Diabetes Costs

30% inpatient hospital care
30% prescription medications
15% antidiabetic agents and diabetes supplies
13% physician office visits

Prescription medications to treat complications of diabetes account for 30% of annual patient and payer expenditures, which is twice or more the amount spent on antidiabetic agents, supplies like lancets and monitors, and even physician visits.

Common Comorbidity

Other chronic conditions experienced by adults diagnosed with diabetes:
69% hypertension
44% high cholesterol
39% chronic kidney disease
12% impaired vision or blindness

When someone with diabetes suffers from more than one condition, it means more doctor appointments, potential procedures or complications, and also the cost of multiple medications to treat underlying conditions.

+$15 OOP cost = -11% adherence

Patient out-of-pocket costs are negatively associated with adherence. For each additional $15 in out-of-pocket costs per month, diabetes medication adherence decreases by 11%.

30%-50%

The percentage of chronic disease treatment failures that are the result of medication non-adherence.

94% would switch

More than nine in 10 people surveyed who skipped a medication due to cost would have been willing to take a lower-cost alternative if their prescriber had suggested one. RxSS notifies every member who has a lower-cost alternative available and works directly with their prescribers to get alternatives approved and prescribed.

9.6%

The portion of all savings realized by RxSS members and clients in 2022 that are for diabetes medications. The percentage is significantly higher when drugs used to treat common associated conditions like hypertension and cholesterol are taken into account.

Convenience = 2x Adherence

Surveyed patients using the mail-order channel were more than twice as likely to be adherent when compared with patients filling their prescriptions at retail pharmacies. In 2022 alone, RxSS converted 17.6% of engaged members from retail to mail-order/delivery.

Affordability Can = Longevity

Wilford Brimley lived to be 85, 41 years after being diagnosed with Type 2 diabetes. He proved the disease can be managed with lifestyle changes and adherence to medication. The latter is no doubt easier financially when you have dozens of film and television credits to your name.

The numbers point to quite different outcomes for many of the 37 million (and counting) people living with diabetes who don’t earn Hollywood money.

A patient can do all the right things—engage with a diabetes point solution, follow a personalized management plan, never miss a doctor visit—but all the gains can be negated if they have to ration or skip medications.

As patients continue to bear more of the cost burden for medication, they need help finding and converting to the lowest-cost, clinically effective treatments available. As shown in the examples below, health plans have financial incentive to do so, as well.

Pharmacy spend aside, as Brimley repeated many times in commercial appearances pitching Quaker Oats: “It’s the right thing to do.”

 

An infographic showing cost savings by switching from one diabetes medication to a clinical alternative
In this recent example, an RxSS member changed to a suggested brand alternative for her originally prescribed insulin. The change is currently saving the member $210 per fill and $340 for her health plan.

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An infographic showing cost savings by switching from one diabetes medication to a clinical alternative
One of our most suggested switches is this change from one generic antidiabetic to another. Notice the member savings is minimal, but the switch saves the plan more than $8,000 annually.
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