Connections - 02.28.22

The Hidden Costs of Diabetes

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by Nicholas F. Castellano, Castle Benefits Consulting Group

Have you ever considered the true hard dollar cost to your health care plan for someone with diabetes? Research shows that when you add the price of extra doctor’s visits, over-the-counter supplies and prescribed medications, the numbers are astronomical. Today more than 30 million Americans live with diabetes, and estimates say that number will rise to over 44 million Americans in the next ten years.  Poor habits such as smoking, inadequate nutrition, and limited physical activity are well-known behaviors leading to these numbers.

Data suggests that one in every seven health care dollars is spent treating diabetes and its complications. Both the costs of diagnosed diabetes and reduced productivity have risen from $245 billion in 2012 to $327 billion in 2017. According to a study by the American Diabetes Association, roughly $90 billion in lost productivity can be broken down by:

  • $3.3 billion in increased absenteeism
  • $19.9 billion in lost productive capacity due to early mortality
  • $26.9 billion in reduced productivity while at work for the employed population
  • $37.5 billion in their ability to work as a result of disease-related disability

Diabetic patients face many other hurdles. They must eat healthier and get more exercise, and most need medication to manage their condition. For people with type 1 diabetes, insulin spending per person increased 97% in recent years, resulting in an average cost of $18,000 per patient per year.

As the percentage of people with diabetes increases, so does spending. Today, 9.4% of Americans have diabetes. These numbers only account for those that have been diagnosed. It is estimated that nearly 1 in 4 adults with diabetes don’t even realize they have the disease.

This has caused a spike in the cost of health care for both employees and employers. Diabetes patients average 2.3 times more costs than those without the disease and people with diabetes pay more for medications (~30% more), increased doctor’s visits and blood tests (13%), related issues such as high blood pressure and cholesterol (27%), and hospital care (30%).

Now that we understand the overall financial aspects affecting employers and employees, what are some solutions?

Most will lean toward putting together a wellness program that will help those with diabetes mitigate other health issues. I agree with that as a preventive measure, but what can be done to help those already diagnosed with diabetes? 

Medication adherence plays a considerable role in the health of a person with diabetes and the financial outcomes. With the rising cost of these medications, people are either skipping their prescribed regimen or, worse, not taking them at all. What if there were a way to take the cost barrier for a number of these medications away, and employees would pay nothing for the medicine? The adherence to their medication regimen would increase, which would cause hospitalization to reduce, improving health and availability.

However, if more people take their medication as prescribed, the cost to the health care plan will increase. While true, reducing the employer cost by over 50% could provide a win-win for both the employee and the employer.

If you would like to learn more about how this can work for you, please do not hesitate to contact Nicholas F. Castellano, or visit us at our exhibit table in Miami during Elevate: 2022 ANCOR Annual Conference. We hope to see you there!