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Diabetes Drug Nonadherence Results in Drastic Health Care Spending Increase

September 05, 2017

Patients with diabetes who did not adhere to their treatment regimens were found to have 1.3 times higher medical costs than those who adhered, according to a recent report published by Express Scripts (August 25, 2017).


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In a new study designed by Express Scripts, a total of 1.4 million patient data were analyzed to assess for diabetes drug utilization and to evaluate patient and outcomes and lowering drug cost strategies.

The pharmacy benefit manager found that patients who were adherent to oral diabetes drugs had 235 fewer emergency department visits and 50 fewer inpatient hospitalizations per 1000 patients, resulting in an average of $500 saved per patients and a total decrease of $210 million in health care spending in 2016.

Patients who were nonadherent were found to have 1.3 times higher medical costs and 4% higher total health care costs compared with adherent patients, a difference of $11,176 vs $10,683, respectively.

Researchers attest that because emergency department use and hospitalizations cost four times and two times as much for patients with diabetes compared with those without the condition, respectively, proper adherence has the ability to save millions of health care dollars. Furthermore, nonadherence to diabetes drugs was found to increase the amount spent, with emergency department use costing 1.5 times more and hospitalizations costing 1.6 times more compared with adherent patients.

However, diabetes drug adherence is trending upwards; adherence increased 3.6% between 2014 and 2016, according to the pharmacy benefit manager. Express Scripts found adherence to oral diabetes drugs to be highest among patients aged 65 years and older (75%). Adherence was almost 65% among patients aged 45 to 64 years, which indicates room for improvement.

Patients aged 20 to 44 years were adherent to diabetes drugs at a rate of less than 50%, highlighting the most significant opportunity to improve adherence, according to the report.

Express Scripts is developing potential solutions to improve adherence. One of which—the Express Scripts Pharmacy home delivery system—has already shown to maintain adherence in 81% of patients. Implementing sustainable lifestyle changes and improving adherence are essential to improving health and lowering health care spending, the report concludes.—Zachary Bessette

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