1157-P: Out-of-Pocket and Health Plan Spending on Diabetes Drugs, 2006-2018

Abstract

The rising cost of managing diabetes is of major concern. To examine trends in expenditures on diabetes drugs, we used OptumLabs Data Warehouse to identify commercially insured and Medicare Advantage enrollees with type 2 diabetes who filled ≥1 diabetes drug between 2006 and 2018. In each year, we examined mean health plan and patient out of pocket (OOP) spending, stratified by health plan (commercial vs. Medicare Advantage), for generic vs. brand, and for insulin vs. non-insulin drugs. We assessed trends using logistic regression. All costs were adjusted to 2018 U.S. dollars. 1,592,663 unique type 2 diabetes patients were included (commercially-insured: 698,725, Medicare Advantage: 893,938). Total mean diabetes drug expenditures increased among all patients (Figure). Among commercially insured patients, OOP spending increased for brand drugs and insulin but decreased for generics (p for trends <0.001). Health plan spending also increased for brand drugs and insulin (p<0.001) but did not change for generics (p=0.32). Among Medicare Advantage enrollees, OOP spending for brand drugs and insulin did not change (p=0.69 and 0.41, respectively), but decreased for generics (p<0.001). Health plan spending increased for brand drugs and insulin (p<0.001) but decreased for generics (p=0.02). Health plan and OOP spending on diabetes drugs increased 2006-2018, particularly among commercially insured patients, those using brand drugs and insulin. Disclosure K.J. Lipska: None. R.G. McCoy: None. H. Van Houten: None. X. Yao: None. J. Ross: Research Support; Self; Centers for Medicare and Medicaid Services, Janssen Pharmaceuticals, Inc., U.S. Food and Drug Administration. A.E. Altan: None. N. Shah: None.