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Oral diabetes agent use is up, but insulin use falls

MANAGED CARE October 2010. © MediMedia USA
The Formulary Files

Oral diabetes agent use is up, but insulin use falls

MANAGED CARE October 2010. ©MediMedia USA

The proportion of Americans reporting treatment for diabetes who took oral medications to treat their condition rose from 60 percent in 1997 to 77 percent in 2007 — a 28 percent increase. During that period, the proportion taking insulin to control their diabetes fell from 38 percent to 24 percent, according to the Agency for Healthcare Research and Quality (AHRQ). It’s understandable, because it is more convenient to take a pill than to give oneself an injection. Less painful, too.

AHRQ’s analysis also revealed a shift in the three most commonly prescribed oral medications during that period. Sulfonylureas were the most prescribed oral antidiabetic in 1997 and still were in 2007, with 5 and 7.6 million people with diabetes using this class of drug. The biguanides (prescribed to 2.1 and 10.4 million, respectively) and thiazolidinediones (prescribed to 0.5 and 4.6 million, respectively) followed.

Although the sulfonylureas were the most widely used class of oral antidiabetes agent in 1997, the proportion changed by 2007.

In 2007, the proportions of people who used the three most commonly prescribed oral medications changed this way: sulfonylureas declined from 51 percent to 40 percent; biguanides rose from 21 percent to 55 percent; and thiazolidinediones increased from 5 percent to 25 percent.

The mean cost per user for all types of antidiabetic medications in constant dollars for 2006–2007 ($944) was nearly twice that in 1997–1998 ($500). In contrast, the mean expenditure per user for sulfonylureas and biguanides decreased from $298 and $381 in 1997–1998 to $211 and $297 in 2006–2007, respectively.

Thiazolidinedione costs rose during that period — from $1,013 in 1997–1998 to $1,121 in 2006–2007. The mean expenditure per user for persons using new antidiabetic medications stood at $1,297 for non-insulin injections and $577 for oral combinations in 2006–2007.

Percentage using orals, insulin, or non-insulin injections, 1997 and 2007 / Per-user expenditures on antidiabetic medications, 1997–1998 and 2006–2007

Source for both graphs: Agency for Healthcare Research and Quality. Statistical brief #293, September 2010