Spending on Diabetes Drugs Nearly Doubles Over Six Years to $12.5B

The cost of diabetes medications in the U.S. increased by 87% to $12.5 billion in 2007 from $6.7 billion in 2001, according to a study published on Monday in the Archives of Internal Medicine, Bloomberg/Boston Globe reports. For the study, -- funded by the Robert Wood Johnson Foundation, the Agency for Healthcare Research and Quality and NIH -- researchers from Stanford University and the University of Chicago analyzed two databases to determine trends in the treatment of patients with type 2 diabetes who visited physicians between 1994 and 2007, as well as information on the cost of diabetes medications from 2001 to 2007.

The study found that the average cost of diabetes medications increased to $76 in 2007 from $56 in 2001 (Bloomberg/Boston Globe, 10/28). In addition, the study found that more patients received multiple prescriptions for diabetes medications as new classes of the treatments became available (Johnson, AP/Houston Chronicle, 10/28). According to the study, 82% of patients in 1994 received only one diabetes medication, compared with 47% of patients in 2007 (Bloomberg/Boston Globe, 10/28). The study also found that the number of patients who visited physicians increased to 19 million in 2007 from 14 million in 2000.

Caleb Alexander, a co-author of the study and an assistant professor of medicine at the University of Chicago, said, "There's been a remarkable change in diabetes treatments and remarkable increases in the cost of treatments over the past several years," adding, "We were surprised by the magnitude of the changes and the rapid increase in the cost of diabetes care" (AP/Houston Chronicle, 10/28). "Are the newer costs worth it, is really the million-dollar question," he asked (Bloomberg/Boston Globe, 10/28).

Metformin Study
A second study published on Monday in the Archives of Internal Medicine found that metformin, a generic diabetes medication available for decades, might reduce risk for death from heart disease, a benefit not provided by Avandia, a newer and more expensive treatment manufactured by GlaxoSmithKline, the AP/Chronicle reports. For the study, funded with federal grants, researchers at Johns Hopkins University analyzed the results of 40 published clinical trials of diabetes medications that examined heart disease risk.

According to the AP/Chronicle, the "findings hint that Avandia has a possible increased risk for heart disease death, but that increase wasn't statistically significant." Researchers cited the "critical need" for long-term studies of diabetes medications and heart disease risks, as few of the trials that they analyzed lasted longer than six months.

In an editorial that accompanied the study, David Nathan, director of the General Clinical Research Center and of the Diabetes Center at Massachusetts General Hospital, wrote, "We need to pay attention to this," adding, "If you can achieve the same glucose control at lower cost and lower side effects, that's what you want to do" (AP/Houston Chronicle, 10/28).

An abstract of the first study is available online. An abstract of the second study also is available online. In addition, an extract of the editorial is available online.

NBC's "Nightly News" on Monday reported on the first study (Williams, "Nightly News," NBC, 10/27).