OBJECTIVE
<p> </p>
<p>We examined
changes in glucose-lowering medication spending and quantified the magnitude of
factors that are contributing to these changes. </p>
<p> </p>
<p>RESEARCH
DESIGN AND METHODS</p>
<p> </p>
<p>Using
the Medical Expenditure Panel Survey, we estimated the change in spending on glucose-lowering
medications during 2005–2007 and 2015–2017 among adults aged 18 years or older
with diabetes. We decomposed the increase of total spending by medication
groups: for insulin by human and analog; and for non-insulin by metformin,
older, newer, and combination medications. For each group, we quantified the contributions
by the number of users and cost-per-user. Costs were in 2017 US dollars.</p>
<p> </p>
<p>RESULTS</p>
<p> </p>
<p>National
spending on glucose-lowering medications increased by $40.6 billion (240%), of which
insulin and non-insulin medications contributed $28.6 billion (169%) and $12.0
billion (71%), respectively.<a> </a><a></a><a>For insulin, the increase was mainly
associated with higher expenditures from analogs</a> (156%). For non-insulin, the increase was a
net effect of higher cost for newer medications (+88%) and decreased cost for
older medications (-34%). Most of the increase in insulin spending came from the
increase in cost-per-user. However, the increase in the number of users contributed
more than cost-per-user in the rise of most non-insulin
groups.</p>
<p> </p>
<p>CONCLUSIONS</p>
<p> </p>
<p><a>The
increase in national spending on glucose-lowering medications during the past
decade was mostly associated with the increased costs for insulin</a>, analogs in
particular, and newer non-insulin medicines; and cost-per-user had a larger
effect than the number of users. Understanding the factors contributing to the increase helps identify ways to curb the growth in costs. </p>