Pediatric Diabetic Spending Sees Jump

Healthcare spending for privately insured diabetic children experienced sharp gains between 2011 and 2013.

Spending for children with diabetes who covered by employer-sponsored insurance (ESI) grew faster than for any other age group with diabetes between 2011 and 2013, according to a new study from the Health Care Cost Institute (HCCI).

The report, Per Capita Health Care Spending on Diabetes: 2009-2013, noted that spending on ESI-covered pediatric sufferers of diabetes grew by 7 percent during 2011 to 2012 and 9.6 percent from 2012 to 2013.

Overall, per capita spending for individuals with diabetes younger than age 65 who were covered by ESI grew by 4.1 percent in 2013, nearly double 2012’s increase of 2.2 percent.

The report was based on the healthcare claims of more than 40 million Americans younger than 65 covered by ESI from 2009 to 2013. HCCI identified 5.3 percent of the ESI population as having diagnosed diabetes (type 1 or type 2) in 2013, up from 4.7 percent in 2009.

“The number of people with diabetes continues to grow, as does the health care spending for these individuals,” said HCCI Executive Director David Newman. “We, and others, need to better understand the relationship between spending and actual health outcomes for people with diabetes, particularly children.”

In terms of dollars, healthcare spending for children with diabetes grew by $1,361 between 2012 and 2013, which was nearly double the increase for young adults ages 19 to 25 ($753), who saw the second largest increase in spending.

The rise in spending for children with diabetes could be partly chalked up to increased spending on branded insulin. In 2013, $2,511 was spent per child with diabetes on branded insulin, which was more than four times what was spent on branded insulin for middle-aged adults ($589) and pre-Medicare adults ($617).  From 2009 to 2013, per capita spending on branded insulin increased 70 percent (by $1,037) for children.

“Moving forward, it will be important to continue to analyze these spending trends to see what else we can learn about how the way we manage diabetes contributes to its costs,” said HCCI Senior Researcher Amanda Frost.

A growing public health concern, diabetes places a considerable financial burden on individuals. For instance, in 2013, people with diabetes spent $14,999 per capita on healthcare. This was nearly 71 percent ($10,700) more than the $4,305 spent per capita for those without the disease.  

Similarly, out-of-pocket costs are growing for diabetes patients, as well. Diabetes sufferers had nearly double the out-of-pocket per capita costs that were more than double that for people without the disease; to the tune of $1,922 compared to $738. Out-of-pocket spending for diabetes patients grew by 3.4 percent on average annually from 2009 to 2013.

Other key findings:

  • Women with diabetes aged 19 to 54 spent more per capita spending than men of the same age with diabetes. The spending difference was greatest between men and women aged 26 to 44. In that case, women in that range spent $3,300 more in 2013.

  • Pre-Medicare adults aged 55 to 64 with diabetes saw the highest per capita spending for any age group. In 2013, those individuals spent $16,889, which was 3.7 percent higher than in 2012 (a $603 jump).


About the Author

David Kopf is the Publisher and Executive Editor of HME Business and DME Pharmacy magazines. Follow him on Twitter at @postacutenews.

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