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Diabetes patients with access to lower-cost medications may be less likely to experience preventable health complications, a February study from researchers at Duke University and not-for-profit health services company Harvard Pilgrim Health Care found.
The researchers examined 10,588 diabetes patients from 2004 to 2017, aged 12 to 64, who were enrolled in a commercial health plan that included a preferred drug list (PDL)—a benefit that can lower costs for medications like insulin. Compared to the control group of 690,075 patients living with the disease who did not have access to a PDL, the research subjects saw “modestly improved short-term health outcomes” when medication was more affordable.
“We can see that their out-of-pocket costs went down,” Frank Wharam, the study coauthor and professor at the Duke-Margolis Center for Health Policy, told Healthcare Brew. “Their medication use went up, and we can see that their complications went down.”
Subjects with a PDL paid an average of $24.10 less per insulin medication and $5.80 less for non-insulin diabetic medications compared to the control group. Diabetes patients in the US spend an average of $150 to $500 on antidiabetic medications each year, according to the study.
Those paying less had an 8% annual reduction in days of diabetes-related complications, such as bacterial infections or acute coronary disease. For every 1,000 diabetes patients, that translates to about 20 fewer days of complications each year. The benefits were even stronger for PDL patients in lower-income areas, the study found; their rate of complications dropped by 10%.
“Once the medical out-of-pocket costs went down, people did use medicines more—and that was more concentrated among low-income people,” Wharam said, referring to a similar study conducted in 2021.
More than 11% of the US population has diabetes, or 38.4 million people, per the American Diabetes Association, with non-white groups experiencing higher rates of the disease. Overall, diabetes costs the US healthcare system about $327 billion each year, with 48%–64% of lifetime medical costs patients with diabetes pay are related to complications, according to the CDC.
According to Wharam, lowering the costs of medications could chip away at those costs.
“Those patients would be sticking to the medicines,” Wharam said. “That would lower things like their blood pressure, their cholesterol, and most importantly, their blood sugar levels for diabetes and make them less likely to have these acute, preventable complications.”