Health care spending rises dramatically for privately insured children with diabetes

Health care spending for privately insured children with diabetes has seen a sharp year-over-year rise between 2011 and 2013, due in part to increased out-of-pocket spending and the rising cost of branded insulin, according to study data from the Health Care Cost Institute.

Per capita spending on children with diabetes rose 7% from 2011 to 2012 and 9.6% from 2012 to 2013, the largest increase of any age group with the disease, according to the report.

The report, “Per Capita Health Care Spending on Diabetes: 2009-2013,” is based on the health care claims of more than 40 million Americans younger than 65 years covered by private insurance from 2009 to 2013.

The Health Care Cost Institute (HCCI), a nonprofit, nonpartisan organization covering national and regional trends in health care, identified 5.3% of the privately insured population as having diagnosed type 1 or type 2 diabetes in 2013, up from 4.7% in 2009. Findings are estimates based on a sample of approximately 25% of privately insured people younger than 65 years.

Per capita spending per child with diabetes rose to $15,456 in 2013, nearly as high as the $16,889 spent per capita on adults with diabetes aged 55 to 64 years, according to the study.

“It is unusual for per capita spending to be so similar for these two age groups,” Amanda Frost, PhD, senior researcher with HCCI, told Endocrine Today. “In addition, spending growth was quite high for children over the last 3 years, as compared to the other age groups.”

Amanda Frost

The $1,361 per capita increase for children with diabetes between 2012 and 2013 was the largest increase for any age group during that period, nearly double the next largest per capita increase of $753 for young adults, according to the study.

Changes in population, increased out-of-pocket spending and increased spending on prescriptions that manage diabetes have influenced the increases, Frost said, adding the prescription costs have had a particular effect on spending for children with diabetes.

In 2013, $2,511 was spent per child with diabetes on branded insulin, more than four times what the average spent on branded insulin for middle-aged adults ($589) and pre-Medicare adults ($617). From 2009 to 2013, per capita spending on branded insulin increased 70% (by $1,037) for children.

“Over the last 3 years, spending on anti-diabetic agents rose, and this was specifically true of branded insulin,” Frost said.

“However, I will say that when spending rises, especially for spending for children, this is not necessarily a bad thing,” she said. “If increased spending is associated with more children receiving care and having positive health outcomes, than we might consider the increased spending a good thing.” – by Regina Schaffer

Reference:

Shakiba, P, Frost A. Per capita health care spending on diabetes: 2009-2013. Health Care Cost Institute. Issue Brief No. 10. May 2015.

Disclosure: Frost reports no relevant financial disclosures.