Healthcare in the United States is something that has been a hot topic in the news in recent years. We have a unique system and when compared to other high-income countries, we spend more money, but we have a lower life expectancy.1
Diabetes is one of the most expensive conditions in the United States. Here are some of the stats:2
- Costing the US $237 billion in 2017
- 1 in 4 dollars spent in healthcare in U.S. are for diabetes
- Person with diabetes on average costs $16,752 each year
In a study from January 2020, researchers looked at the estimated lifetime financial burden for people with diabetes and found that people with type 1 diabetes have a significantly higher lifetime cost compared to healthy controls.3 Another study from June 2021 found that hypoglycemia increases the financial burden for people with diabetes, their employers and those who pay for their healthcare.4
The financial burden is such a significant problem for many folks with diabetes that they resort to swapping diabetes medications or supplies. Over half of 159 people in a 2020 study reported exchanging diabetes supplies out of necessity, drawing attention to how common the practice is.6 I may or may not have personal experience with this…
One of the highest expenditures related to diabetes in the U.S. are preventable hospitalizations of young adults, ages 18-44.2 Additionally, according to the State of Type 1 Diabetes from the T1D Exchange, 85% of young adults aged 18-25 with type 1 diabetes are not meeting the target of an HbA1C <7%.6
Dr. Julia Blanchette published an article in April 2021 focusing on Financial Stress in Emerging Adults with Diabetes to put some focus on this area.7 Blanchette and her fellow authors collected surveys from 413 emerging adults from the T1D Exchange Clinic Registry about financial well-being, diabetes distress, diabetes quality of life, and more.
The participants data showed of the 413 participants:4
- 45% felt high levels of financial stress
- 63% had high risk for anxiety
- 4% had moderate to high levels of diabetes distress
- 1% said their most recent HbA1C met the goal of <7%
- Higher levels of financial stress and distress were associated with higher HbA1C levels
Dr. Blanchette states, “What sticks out the most about our findings is we now have some data to support a pretty significant problem that we have seen clinically, and that we have heard many personal and news stories about. Financial stress and diabetes distress have negative impacts on self-management outcomes in young adults with T1D.”
In another study from Dr. Blanchette and colleagues from 2022, the authors found emerging adults’ concerns related to finances had common themes which included affordability, managing insurance, talking to healthcare providers & pharmacies, and the emotional burden of the financial strain.8 Dr. Blanchette added, “We still need to do more research in the financial stress area as it’s lacking, but we can use these findings to begin to figure out better ways to support young adults with T1D.”
It’s very common for us to receive questions submitted by the diabetes community related to finances, donation of supplies, how to reduce costs, and issues with insurance coverage. There was one question asking about how long someone newly diagnosed could survive without insulin just weeks after someone asked how long someone with type 1 can go without insulin.
These examples do not specifically say that the cost of insulin is a barrier, but it’s hard to believe that it did not contribute to them asking the questions. But it inspires hope when we receive many requests to donate insulin or diabetes supplies. It’s as if the diabetes community has decided that even if our healthcare system in the U.S. won’t take care of us, we will take care of each other.
We have a page about Prescription Laws and Access to Insulin Resources with a number of valuable resources. CWD’s YouTube channel has a number of videos that provide insight and resources for people with diabetes, including:
- Diabetes on a Budget – Manufacturer’s Coupons, Using the Pharmacy Benefit, and Other Resources
- FFL Orlando 2022: Federal Update: Will They Ever Lower the Cost of Insulin and Other Drugs?
- Affordable Access to Insulin
- S. Health Care from a Global Perspective, 2019: Higher Spending, Worse Outcomes?
- The Cost of Diabetes Care—An Elephant in the Room
- Estimated Lifetime Economic Burden of Type 1 Diabetes
- Economic burden of diabetes-related hypoglycemia on patients, payors, and employers
- State of Type 1 Diabetes Management and Outcomes from the T1D Exchange in 2016–2018
- The Underground Exchange of Diabetes Medications and Supplies: Donating, Trading, and Borrowing, Oh My!
- Financial Stress in Emerging Adults with Type 1 Diabetes in the United States
- Financial Barriers in Emerging Adults With Type 1 Diabetes: A Qualitative Analysis
Written and clinically reviewed by Marissa Town, RN, BSN, CDCES