Costs of diabetes care over time: Changes and components

For Americans with diabetes, the increased level of medical care required to treat diabetes means a higher level of related expenditures. To identify how much higher expenditures are for diabetes, and how this excess expenditure has changed over time, we evaluated nine years of MEPS Household Component data. We find that total expenditures increased more for persons with diabetes than for persons without diabetes, by roughly 17% over the nine years of data, with an estimated excess effect of $4,121 (2010 USD) in 2000 to $5,140 in 2003; the excess remained close to $5,000 throughout the remaining period. Prescription medication expenditures are the largest driver of this increase in cost ; the marginal effect of diabetes on prescriptions filled increased over this time period (20 additional prescriptions in 2000, vs 23 in 2008). Among other evaluated categories, the effect of diabetes has remained relatively stable over time. The marginal effect on office-based provider visits remained between 3.4 and 3.9 additional visits per year, with the marginal effect on related expenditures increasing from $658 in 2000 to a high of $861 in 2007, but generally remaining around $800 from 2004 onward. The effect of diabetes on hospital events is rather muted, with slight effects upon inpatient stays and emergency department visits and a somewhat greater effect on outpatient visits. Overall, diabetes leads to about 1 additional hospital event per year, and expenditures on hospital events for persons with diabetes are about $2,000 per year greater than for persons without diabetes.