The Rising Costs of Treating Type 2

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A study published this week in the journal Archives of Internal Medicine has put the spotlight on the rising cost of Type 2 diabetes drugs. According to researchers from the University of Chicago, the University of California, San Francisco, and Stanford University, spending on diabetes drugs increased by 87% between 1994 and 2007, from $6.7 billion to $12.5 billion.

Part of the reason for this increase is that more people are being diagnosed with and treated for Type 2 diabetes. Also, doctors are prescribing more drugs to each person (the average number of drugs prescribed per appointment rose from 1.06 to 1.45 over the course of the study). However, the researchers concluded that “the greatest contributor to increasing costs is the substantially greater use of newer, more costly medications.”

The researchers discovered what they called “significant shifts” in the medicines used to treat Type 2 diabetes since 1994. They found that the average cost of a Type 2 diabetes drug prescription was $76 in 2007, compared to $56 in 2001, due in large part to the increased use of thiazolidinediones (rosiglitazone [brand name Avandia] and pioglitazone [Actos]), insulin analogs, sitagliptin (Januvia), and exenatide (Byetta). Unlike the older sulfonylurea drugs and metformin, none of these newer drugs is available in generic form.

These findings are especially interesting in the context of the updated Type 2 diabetes treatment guidelines that were released last week (read more about them here), which recommend using the older, more proven, and less expensive treatments metformin and sulfonylureas before newer, more expensive therapies such pioglitazone and exenatide. The researchers commented that there has been a rise in “off-label” use of thiazolidinediones and exenatide as single, first-line treatments for Type 2 diabetes even though they are approved by the FDA only as add-on treatments to other medications.

In the study’s conclusion, the researchers questioned whether the use of more expensive diabetes treatments will result in proportionally improved outcomes. What do you think? Have you had good results with older diabetes drugs? Do you believe that some of the newer therapies are worth the higher cost? Share your thoughts with a comment below.

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