Cost of diabetes care in US rises to $412.9 billion in 2022
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Key takeaways:
- Health care expenditures attributed to diagnosed diabetes totaled $412.9 billion in the U.S. in 2022.
- Care for people with diabetes accounts for about 25% of the total health care expenditures in the U.S.
The total annual cost of caring for Americans with diabetes in 2022 was an estimated $412.9 billion, and one in four total health care dollars in the U.S. went toward diabetes care, according to a report.
The American Diabetes Association published its Economic Costs of Diabetes in the U.S. in 2022 report in Diabetes Care to assess the financial burden for people living with diabetes. According to the report, overall medical costs for people with diabetes increased by about 7% from 2017 to 2022 after adjusting for inflation. Raveendhara R. Bannuru, MD, PhD, FAGE, vice president of medical Affairs and quality improvement outcomes, and senior author of the report for the ADA, noted the number of people with diabetes increased in that same period, leading in part to higher expenditures. In 2012, the total cost of diabetes spending was $315.6 billion after adjusting for 2022 dollars.
“All facets of diabetes care costs are increasing, and we are all in it together,” Bannuru told Healio. “We urge all the stakeholders to work together to come up with innovative solutions to reduce the costs in every facet of diabetes care.”
The ADA’s Economic Costs of Diabetes in the U.S. report is conducted every 5 years. The organization calculates the estimated prevalence of diabetes, health care use and medical costs at the state and national level to estimate the cost of diabetes care. Institutional care, outpatient care, medication and supplies are combined to form direct costs attributable to diabetes care. Indirect costs include productivity loss, costs related to an inability to work due to disability and premature mortality. Health resource use and costs were analyzed by age, sex, race and ethnicity, comorbidities and health service category.
Direct and indirect costs rising
In 2022, about 25.5 million people in the U.S. had diabetes, a 3% increase from 2017 and 14% increase from 2012. Of the total adult population, the prevalence of diabetes was 9.6%. The estimated total cost of diabetes care in the U.S. was $412.9 billion in 2022, of which $306.6 billion was related to direct expenditures and $106.3 billion were indirect expenditures.
Total direct costs attributed to diabetes increased by about $80 billion over the past 10 years from $227 billion in 2012 to $306.6 billion in 2022 after adjusting for inflation. Total indirect costs of diabetes also increased from $88.6 billion in 2012 to $106.3 billion in 2022. The average total health care expenditures per year for a person with diabetes is $19,736 compared with an average annual health care costs of $7,714 for a person without diabetes.
Excess costs associated with all prescribed medications made up 44% of the total medical burden, whereas in 2012, excess costs associated with medications consisted of 28.4% of the total medical burden. The total cost of insulin and other glucose-lowering medications increased by 26% from 2017 to 2022, and the inflation-adjusted cost of insulin alone increased by 24%.
Bannuru noted the data on insulin costs came prior to the implementation of out-of-pocket insulin caps, which have been announced by both the federal government and pharmaceutical companies in 2023.
“ I think we’ll see some benefits of this legislation in the future,” Bannuru said. “We should have data to estimate the effects of this legislation on the costs of diabetes care in our next update.”
More studies on disparities needed
When demographics were analyzed, about 67% of all health care expenses related to diabetes are for health resources used by adults aged 65 years and older. The average cost of diabetes care per person is $17,180 for adults aged 65 years and older compared with $7,482 for those younger than 65 years. Per capita diabetes costs were higher for women at $12,376 vs. $11,680 for men. When race and ethnicity were analyzed, Black people with diabetes had the highest mean cost per person at $13,169, followed by white people at $13,039. The lowest average diabetes cost per person was for Hispanic individuals with a mean cost of $8,865.
Bannuru said the data did not allow the authors to take a deeper dive into other populations, such as analyzing separate costs for Medicare and Medicaid beneficiaries.
“Most of the databases we used were government databases,” Bannuru said. “These databases at this point of time do not contain those granular details. Enriching these databases with all this information, which is pertinent to all the health disparities and how we can account for them, would definitely help us address this issue in the future reports.”
The report cites indirect costs as a contributing factor to rising diabetes expenditures. Of the estimated 25.5 million people with diagnosed diabetes, about 8.2 million are in the workforce. According to the report, if people with diabetes participated in the labor force at a similar rate as those without diabetes, there would be an additional 2 million people aged 18 to 64 years in the workforce. Reduced work productivity accounted for $35.8 billion in indirect diabetes costs and missed workdays accounted for $5.4 billion in costs.
Bannuru said all stakeholders need to get involved to come up with innovative ways to reduce diabetes costs. One way providers can help lower expenditures is by diagnosing and treating diabetes early to prevent long-term complications within their own patient population.
“Diabetes is a chronic disease and very expensive to manage over the long-term. It can lead to several chronic complications if you do not manage it well,” Bannuru said. “That means you need to start managing diabetes early to prevent or delay complications. For example, preventing an amputation or a heart attack would be useful because that person would be in the workforce longer and also it means the family can live a better life. Though the initial cost might be slightly higher, the long-term benefits would be higher when you look at the life span of a person.”
For more information:
Raveendhara R. Bannuru, MD, PhD, FAGE, can be reached at rbannuru@diabetes.org.
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