Chronic Disease

Newest diabetes medications are more costly and widely prescribed than older diabetes drugs

Accompanying the increase in the number of Americans diagnosed with Type 2 diabetes is the number of new drug classes available to treat this chronic condition. A new study finds that the newest drugs are more expensive and prescribed more frequently than the traditional drugs, whose use has declined. For instance, in 2001, the average price of a diabetes medication was $56. In 2007, that average rose to $76. During that same period, expenditures for diabetes drugs swelled from $6.7 to $12.5 billion nationally, an 87 percent increase.

The newer drugs to treat diabetes (including insulin analogues, glitazones, exenatide, and sitagliptin) have high price tags. They can cost 8 to 10 times more than the older drugs (insulin and sulfonylureas). However, analyses have not shown that the newer diabetes drugs offer better outcomes than the traditional drugs, according to G. Caleb Alexander, M.D., M.S., of the University of Chicago.

The authors also point out that the U.S. Food and Drug Administration approved glitazones and exenatide to be used in combination with other diabetes drugs. However, they are now being used off label as stand-alone drugs to control diabetes. This prescribing practice could pose a health risk to patients because safety assessments for the drugs have not been completed. The researchers used diabetes data from the National Disease and Therapeutic Index from 1994 to 2007 for this study, which was funded in part by the Agency for Healthcare Research and Quality (HS15699).

See "National trends in treatment of Type 2 diabetes mellitus, 1994-2007," by Dr. Alexander, Niraj L. Sehgal, M.D., M.P.H., Rachael M. Moloney, B.A., and Randall S. Stafford, M.D., Ph.D., in the October 27, 2008, Archives of Internal Medicine 168(19), pp. 2088-2094.

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