Women More Likely Than Men to Ration Diabetes Meds Due to Cost, CDC Says

Women are more likely than men not to take their diabetes medication as prescribed in an effort to control prescription drug costs, as are adults under age 65, according to a report published this month by the Centers for Disease Control and Prevention (CDC).

The August data brief used data from the 2017-2018 National Health Interview Survey (NHIS), looking who was more likely to ration diabetes medications as a cost-savings measure during the past 12 months.

Despite a recent shift to lower-cost options as the first line of diabetes therapy, the burden of high prescription drug costs remains a public health concern, the CDC noted. The price of insulin has been the topic of numerous hearing on Capitol Hill, and some companies have responded by introducing authorized generics or by capping prices as the wait for cheaper biosimilar insulin continues. Rationing of insulin and other supplies needed to manage diabetes is known to be a worldwide problem.

Last year, diabetes medications ranked sixth out of the top 20 therapeutic classes of dispensed prescriptions, accounting for 214 million prescriptions. In 2017, the annual per capita expense for outpatient diabetes medication was almost $5000, the CDC said.

Among adults with diagnosed diabetes, women (14.9%) were more likely than men (11.6%) not to take their medication as prescribed, although they were as likely to ask their doctor for a lower-priced medication (25.5% vs 23.4%).

The survey also found that uninsured adults aged 18 to 64 years were more likely than those with private insurance or Medicaid to not take their medication as prescribed and to ask their doctor for a lower-cost drug. Almost 36% of the uninsured did not take medication as prescribed, compared with 14% of those with private health insurance and nearly 18% of those with Medicaid coverage. Likewise, 42.6% of uninsured adults were more likely to seek out cheaper prescriptions, compared with patients who had private coverage (25.7%) or Medicaid coverage (18.8%).

Younger adults were more likely than those aged 65 and over to not take their medication as prescribed (17.9% and 7.2%, respectively) and to ask their doctor for a lower-cost drug (26.3% and 21.9%, respectively).

Among adults aged 65 and over, the percentage who did not take their diabetes medication as prescribed did not vary significantly by coverage type (private coverage, Medicare and Medicaid, Medicare Advantage, traditional fee-for-service Medicare only, other coverage, or no insurance), ranging from 6.2% for those with private insurance to 9.2% for those with traditional Medicare.

Within this group, the percentage of patients who asked their doctor for a lower-cost diabetes medication was lowest among those with Medicare and Medicaid coverage (13.0% each) compared with private (26.1%), Medicare Advantage (25.8%), or Medicare only (22.7%) coverage.