Rising cost of diabetic medications impact individuals as well as Medicaid and Medicare


Rising costs of metabolic agents, particularly those used in the treatment of diabetes, impacts patients and the medical systems, such as Medicare and Medicaid.

Image credit: AdobeStock/Vitalii Vodolazskyi

(Image credit: AdobeStock/Vitalii Vodolazskyi)

Published research from the University of Houston College of Pharmacy shows rising prescription drug expenditures in the United States being led by diabetic medications, including insulin.

Researchers found that from 2011 to 2020, total annual prescription medication expenditures rose from $341.49 to $473.12 billion per year in the US. Of these expenditures, metabolic agents were the costliest category. Among the metabolic agents, anti-diabetic agents were the most expensive therapeutic area, with an increasing trend observed from $27.15 to $89.17 billion over the same period.1

Treatment and active management of diabetes is crucial for a patient’s overall health. Ophthalmologists recognize the importance of proper blood sugar monitoring and insulin injections among other therapeutic tools to support those patients who are at risk for diabetic macular edema and diabetic retinopathy. Increasing costs may result in a patients inability to manage their disease effectively should the cost be burdensome.1

“Despite observed trends in medication expenditures, very little effort has been made to understand how those trends vary by therapeutic class,” reported Tyler Varisco, assistant professor of Pharmaceutical Health Outcomes and Policy and assistant director of the Prescription Drug Misuse Education and Research Center in the journal Research in Social and Administrative Pharmacy in the press release.1 Varisco and Whanhui Chi, a second-year doctoral student in Pharmaceutical Outcomes and Policy, conducted a cross-sectional analysis to identify determinants of increasing medicine expenditures in the U.S. between 2011 and 2020.

To do this analysis, Varisco used prescription medication expenditures from the Medical Expenditures Panel Survey. He calculated total annual medication expenditures by payer categories (Out-of-pocket, Medicare, Medicaid, TRICARE/Veterans Administration/CHAMPVA (TVAC), Other Government Sources, Private Insurance, and Other Sources). The data showed that spending by Medicare ($38.23 billion) and Medicaid ($8.68 billion) accounted for almost half of all US spending on metabolic agents in 2020.1

Following this, Varisco also found the growth in prescription drug expenditures in the US can be ascribed to several different factors, which include population demographics, changes in technology, and healthcare practice. For example, total Medicare enrollment was found to be 48,892,758 in 2011, which later reached 62,840,267 in 2020.1

Varisco shared the importance of continuing research in this area, saying, “In light of these developments, research is needed to substantiate concerns that trends in the cost of care are outpacing patients’ ability to pay. Continuing analysis is needed to help policymakers and other key stakeholders understand how changes in practice, policy, and drug marketing converge to impact total market expenditures.”1

1. UH College of Pharmacy Researcher Examines Trends in Rising Cost of Medicine. University of Houston. Published April 10, 2024. Accessed April 16, 2024. https://uh.edu/news-events/stories/2024/april/04102024-rise-prescription-rx-varisco.php
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