Chronic Disease

Diabetes treatment involves more multidrug regimens and high financial burden

Over the last several years, the care and treatment of patients with diabetes has changed considerably, including the introduction of more expensive drug therapies. A new study finds that nonelderly patients with diabetes are increasingly being treated with multidrug regimens and that the proportion of family income spent by nonelderly patients on health care remains high.
Eric M. Sarpong, Ph.D., Didem M. Bernard, Ph.D., and G. Edward Miller, Ph.D., of the Agency for Healthcare Research and Quality (AHRQ), recently examined changes in diabetes care and financial burden of treatment. They analyzed AHRQ's Medical Expenditure Panel Survey data from two time periods: 1997–1998 and 2006–2007. They identified nonelderly adults with diabetes and also identified their coexisting conditions, such as cardiovascular disease, hypertension, and disorders of lipid metabolism (e.g., hyperlipidemia).
The researchers assessed patients' drug use, expenditures, and their family financial burden for diabetes care. Between the two time periods studied, the total number of nonelderly adults treated for diabetes nearly doubled, representing 5.7 percent of the total United States population in 2006–2007. The prevalence of treated coexisting conditions also grew significantly, including a tripling of lipid disorders. There was also a change in the use of multidrug regimens. The proportion of those using two or more oral drugs increased from 15.7 percent to 30.1 percent. In terms of family financial burden, approximately one-fifth of patients spent 10 percent or more of their income on health care. One in nine spent 20 percent or more. Higher financial burdens were experienced more by patients who were older, female, had poor health, or were uninsured. The authors note that this financial strain may result in inadequate treatment of some patients with diabetes.
More details are in "Changes in pharmaceutical treatment of diabetes and family financial burdens," by Drs. Sarpong, Bernard, and Miller in the August 2012 Medical Care Research and Review 69(4), pp. 474-491. Reprints (AHRQ Publication No. 12-R079) are available from the AHRQ Publications Clearinghouse.

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