OBJECTIVES

High Out of Pocket (OOP) costs may act as a barrier to health care access and treatment compliance in diabetes care. We explored the burden of pharmaceutical OOP costs among individuals with diabetes and analyzed trends across multiple years using a nationally representative sample.

METHODS

Retrospective, cross sectional research data was obtained from the Medical Expenditure Panel Surveys (MEPS), for the years 2011 through 2015. Individuals (>17 years) with diabetes were identified using a self-reported question. Per-individual annual OOP cost for anti-diabetic medications were calculated by aggregating all OOP cost for these medications within each year. Multivariable generalized linear models with a log-link function and gamma distribution were used to produce adjusted comparisons of OOP costs across the years. The complex survey design of MEPS was incorporated by using sample weights for stratum, cluster, and individual persons to produce national estimates. Statistical analyses were performed using SAS software (version 9.4 SAS Institute Inc., Cary, NC, US).

RESULTS :

From 2011 through 2015, 10,250 individuals having diabetes were identified. The mean annual OOP for diabetic medications among diabetics for 2011 to 2015 was $308.98, $294.49, $286.06, $247.58 and $326.54 respectively. Similarly, between 2011 and 2015, the out of pocket cost for these diabetic medications accounted for 47.16%, 45.19%, 42.02%, 38.54% and 33.16% respectively of the total out of pocket drug expenditure.

CONCLUSIONS :

Our findings demonstrate a steady decrease in OOP on anti-diabetic medications among diabetics from 2011 to 2014, followed by a dramatic rise in 2015. The proportion of the total out of pocket drug costs that these anti-diabetic medications accounted for showed a steady decrease from almost half the total costs in 2011 to a third of the total costs in 2015.