The cost of covering someone with diabetes has skyrocketed this decade while use only rose modestly, according to a new report by the nonprofit research Health Care Cost Institute.
The average cost of managing Type 1 diabetes in employer-sponsored health insurance plans rose from $12,467 in 2012 to almost $18,500 in 2016. The group said 47% of that increase came from higher insulin prices.
The per-person cost for insulin increased from $2,900 in 2012 to $5,700 in 2016 — driven almost entirely by point-of-sale price increases. The analysis did not look at rebates or out-of-pocket costs for patients.
Diabetes is a major health cost driver, and prevalence is only expected to increase as 86 million Americans adults are estimated to have prediabetes.
Now, the cost of insulin is rising and patients could be faced with sacrificing their insulin for other necessities. Forgoing insulin would make their health worse, which will only increase healthcare costs. The American Diabetes Association said costs associated with the more than 30 million people with diabetes in the U.S. are more than double those without diabetes and estimates that diagnosed diabetes costs the U.S. $327 billion annually.
CMS is testing demonstration projects to bend the cost curve, but rising insulin prices could be another trend that makes it hard to keep healthcare costs under control.
For the HCCI study, researchers looked at health insurance claims from between 13,800 and 16,200 people with Type 1 diabetes in employer-sponsored plans. The disease affects about 1.5 million Americans.
Every insulin product increased in cost between 2012 and 2016. The median price increased by 92% in that period, according to the report.
Insulin cost growth exceeded other costs, including non-insulin prescriptions, inpatient and outpatient care.
The authors said the findings are consistent with anecdotes of patients not being able to afford insulin. Niall Brennan, CEO of HCCI, said it's difficult to square the increases with the fact that the drug hasn't really changed.
"We are frequently told that high drug prices are justifiable in order to promote innovative new cures, but the cost of insulin — a longstanding therapy that 1.25 million Americans with type 1 diabetes rely on to live — has nearly doubled in the last five years, despite very little change in the underlying product," Brennan said in a statement.
The research found that shortages or increased need weren't to blame for the price increase. HCCI said insulin use went up just 3% over the period. Insulin delivery methods are changing, though. Syringes remain the most common method (53% of insulin used in 2016), but that usage declined from 61% in 2012. Meanwhile, prefilled insulin pens are becoming more common, having increased from 38% of usage in 2012 to 46% in 2016.