Reducing the economic burden of diabetes in the United States

Diabetes is one of the most costly diseases in the United States, with one out of every four health care dollars going toward care for people who have been diagnosed with the disease. According to the American Diabetes Association, the economic burden of diabetes has risen 26 percent over the last five years—from $245 billion in 2012 to $327 billion in 2017. That number is expected to nearly double by 2030, with total annual medical and societal costs estimated to reach more than $622 billion.

 

Why the increase?

The increased economic cost of diabetes is largely due to the increased prevalence of the disease and escalating medical costs per person with diagnosed diabetes. According to a recent article in Diabetes Care, the prevalence of diabetes in the United States increased 11 percent between 2012 and 2017. During the same period, medical costs per person rose 13 percent.

Rising obesity rates and prices for newer drugs are also contributing to the growing economic burden.

 

The role of the physician in reducing the economic burden

Despite the United States ranking 4th among 11 leading developed countries in the delivery of diabetes care, the National Institutes of Health says, “the United States needs to enhance the delivery of services to provide better support for individuals with diabetes.” Physicians are integral to the delivery of these services. As such, they can play a significant role in reducing the economic burden of diabetes in the United States by, among other things, providing appropriate medical care that incorporates current, evidence-based interventions.

On the surface, this sounds straightforward. However, the near-constant release of new information and research is making what constitutes appropriate medical care something of a moving target.

To keep pace with the staggering rate at which new information and research is being released, the ADA announced that beginning this year, the online version of its Standards of Medical Care in Diabetes will become a living document, with updates and revisions being made throughout the year if new evidence or regulatory changes merit immediate incorporation.

 

Can appropriate care also be cost effective?

There are a number of cost-effective interventions circulating the literature:

  • An analysis of 3,017 adults with diabetes showed a strong correlation between glycemic control and care costs, with medical charges increasing significantly for every 1 percent increase in A1C above 7 percent. Intensive glycemic management can reduce treatment costs and is associated with improved clinical outcomes for patients with diabetes.
  • Studies indicate that not only do lifestyle interventions delay the onset of type 2 diabetes, the benefits of these interventions may persist for as many at 20 years. Recent analyses indicate that lifestyle interventions were cost effective, intensive lifestyle interventions were extremely cost effective, and metformin treatment may result in cost savings over a ten-year period.

 

Diabetes is a complex disease that requires a multifaceted set of interventions. Moving to team-based care may also help to improve outcomes, reduce physician burnout, and contain costs.

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