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New diabetic drugs: expensive, but maybe not better

Researchers from Stanford University Medical School and the University of Chicago report that between 2001 and 2007, expenditures for diabetic drugs in the US nearly doubled. Their report, which is published in the October 27, 2008 issue of Archives of Internal Medicine, asserts that the cost of prescription diabetic medications increased from approximately $6.7 billion to $12.5 billion. The increased cost of newer drugs is cited as a major cause of the rising cost of treating diabetes.

New diabetic drugs: More benefits for higher costs?

The following findings support the urgent need for controlling health care costs associated with diabetic care:

    1. The American Diabetes Association (ADA) estimates that the cost of treating diabetes in 2007 was approximately $174 billion. This amount includes $116 billion in healthcare costs and an estimated $58 billion in lost productivity caused by diabetes related issues.
    2. When you include the medical costs of those with pre-diabetes, gestational diabetes and undiagnosed diabetes, the cost of treatment could exceed $218 billion.
    3. Medical costs for those with diabetes are more than twice the cost than for those who do not have the disease.
    4. Consumer Reports found routine diabetes care can cost an individual about $6,000 per year.
    5. Newer diabetic drugs can sell for as much as ten times the price of older medications.
    6. Between 2001 and 2007, the average cost of diabetes medication increased from $56 to $76. This trend is largely attributed to the higher cost of newer diabetes medications.

      One of the authors of the Stanford-University of Chicago study, G. Caleb Alexander, MD, argues for studies comparing the benefits of new diabetic drugs with those of older drugs that cost considerably less. Proponents of newer medications assert they are more efficient at controlling blood sugar levels. Determining the added benefits of more expensive medications is particularly significant in view of rapidly growing numbers of diabetics.

      Increasing cases of diabetes highlight need for affordable medications

      The soaring numbers of diabetes diagnoses emphasizes the need for cost-effective control of symptoms:

      • In 2010, 18.8 million people were diagnosed with diabetes, compared to 11 million in 2000.
      • The number of patients seeing a doctor about their diabetes increased from 14 million in 2000 to 19 million in 2009.
      • Estimates suggest that nearly 7 million people in the US have diabetes, but have not been diagnosed.
      • 79 million Americans may have pre-diabetes, a condition that occurs when blood glucose levels are higher than normal, but not high enough for a diagnosis of diabetes.
      • Pre-diabetes can increase the risk of heart attack and stroke by 50 percent or more.

      Diabetic care = quality and cost

      Health care professionals are increasingly prescribing multiple medications to assist patients in controlling diabetes and related conditions. The trend toward treating patients with multiple medications is supported by the findings of a study of two pharmaceutical company databases covering prescription diabetic medications in 2007:

      • Patients treated with only one diabetes medication decreased from 82 percent to 47 percent
      • Prescriptions for older diabetic drugs decreased from 67 percent to 34 percent

      Consumers are typically charged more for newer, patented diabetic drugs than for older generic medications. However, a study completed by Consumer Reports Health in February 2009 indicated that older, generic drugs were just as effective as newer, more expensive drugs in treating diabetes.

      Generic versus brand name diabetes drugs

      A patented prescription medication is a medication that can only be manufactured and sold by its inventor. Once the patent expires, competitors can apply to the Food and Drug Administration (FDA) for permission to produce generic versions of the drug. Here are three points about generic and brand name drugs to consider.

      • Generic medications are usually identical versions of brand-name medications. Brand names are typically capitalized (Glucophage), while generic names are not capitalized. An example of a generic diabetic drug is metformin, which is the generic version of Glucophage.
      • The FDA requires generic medications to be as safe and effective as name-brand medications. Again, generic versions of diabetic drugs are typically exactly the same as brand-name medicines. The reason generics are much cheaper is that their manufacturers do not bear the high cost of initial research, development, and marketing required of the original manufacturer. Generic medications should work as well as brand-name medications.
      • Generic medications may contain different inactive ingredients: US trademark laws do not allow generic versions of medications to look exactly the same as brand-name products. For this reason, inactive ingredients and outward appearance (color or shape) can vary from the original brand-name products. These differences can lead to the mistaken belief that a generic version may be inferior to a brand-name prescription medication.

      In light of the study from the University of Stanford and the University of Chicago, the debate about generic versus brand name medications is sure to continue.

      Article sources  expand

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