TRENTON, N.J. - As diabetes is rapidly becoming one of the world's most common diseases, its financial cost is mounting, too, to well over $200 billion a year in the U.S. alone.
A new study, released Tuesday exclusively to The Associated Press, puts the total at $218 billion last year - the first comprehensive estimate of the financial toll diabetes takes, according to Danish pharmaceutical company Novo Nordisk A/S, which paid for the study.
That figure includes direct medical care costs, from insulin and pills for controlling patients' blood sugar to amputations and hospitalizations, plus indirect costs such as lost productivity, disability and early retirement.
The $218 billion amounts to about 10 percent of all U.S. health care spending by government and the public, about $2.1 trillion in 2006, according to the Centers for Medicare and Medicaid Services. Direct and indirect U.S. costs of our top killer - heart disease and stroke - will total about $448.5 billion this year, according to the American Heart Association.
The study, conducted by the Lewin Group consultants, estimates costs to society for people known to have Type 1 or Type 2 diabetes at $174.4 billion combined, a total previously reported by Novo Nordisk, the world's top producer of insulin and the maker of diabetes pills such as NovoNorm and Prandin. That study was done with the American Diabetes Association.
The new study adds estimates for people who haven't been diagnosed yet ($18 billion), women who develop diabetes temporarily during pregnancy ($636 million) and those on track to develop diabetes, an increasingly common condition called pre-diabetes ($25 billion).
"Diabetes has not seen a decline or even a plateauing, and the death rate from diabetes continues to rise," said Dana Haza, senior director of the National Changing Diabetes Program, an effort Novo Nordisk began in 2005 to improve diabetes care and prevention in the U.S.
"The numbers just keep going higher and higher, and what we want to say is, 'It's time for government and businesses to focus on it,'" said Haza, who believes diabetes will be the country's biggest health problem in the future, worsened by the obesity epidemic.
Already, the federal government spends more than $85 billion a year - about one in eight health care dollars - on treatment of people with diabetes, disability payments to them, research and related efforts.
Novo Nordisk is to present its data Tuesday at a health care conference for corporate executives and then plans to publish a full report in a professional journal. The calculations are based on numbers from sources including databases on treatment of people with commercial insurance, Medicare and Medicaid, federal public health surveys and other sources.
Andrew Webber, president and chief executive of the National Business Coalition on Health, said the study is the first he's seen estimating diabetes costs. He praised its inclusion of indirect costs, which "add up and create such a powerful argument as to why employers need to take this challenge on."
"This study gives a very persuasive argument to employers to invest in a culture of health in their workforce," Webber said, calling the worsening diabetes epidemic "the tsunami that is coming."
Among people known to have diabetes, the new study estimated $10.5 billion in medical costs and $4.4 billion in indirect costs, or a total of $14.9 billion, for people with Type 1 diabetes, which generally begins in youth and can have a genetic link. Nearly 6 percent of the 17.5 million Americans diagnosed with diabetes have Type 1.
The study estimated $105.7 billion in medical costs and $53.8 billion in indirect costs, totaling $159.5 billion, for people with Type 2 diabetes, previously called adult-onset diabetes because of its link to the bigger waistlines and sedentary lifestyles of middle age.
The National Changing Diabetes Program, which includes medical partners such as the American Academy of Family Physicians and American Diabetes Association, wants more Americans at risk of diabetes to know their blood sugar level and control it. It also wants the White House to appoint a coordinator for diabetes prevention and education.
Meanwhile, plenty of companies have started their own efforts, said Webber, whose group includes 61 business coalitions with about 7,000 employers and 35 million employees and dependents.
Webber said six of those coalitions are running programs giving participating employees diabetes medicines without a co-pay, six more give doctors extra money for helping patients get their diabetes under control, and one coalition offers both types of programs.
"My guess is we need to do both," to prevent complications and improve worker productivity, Webber said.
Tuesday, November 18, 2008
Saturday, November 15, 2008
less than 50% of type 2 diabetes patients* are achieving target
New worldwide research indicates that, less than 50% of type 2 diabetes patients* are achieving target long-term blood glucose measures (HbA1c)1, and 40% of patients are experiencing diabetes complications2. These results are being announced in support of World Diabetes Day (WDD), an annual campaign run by the International Diabetes Federation. WDD also heralds the beginning of a national search to find 'The Face of Diabetes'.
The Diabetes Impact Survey commissioned by Merck & Co., Inc., known in many countries as Merck Sharp & Dohme, was developed with a steering panel of world-renowned medical, scientific and clinical professionals in the field of diabetes. Key findings include:
- According to the healthcare professionals surveyed, less than 50% of their patients are achieving their target HbA1c goal, a measure of long-term blood glucose control1
- A survey of patients indicated that 40% reported complications associated with their disease2
National Search for 'The Face of Diabetes'
People with diabetes are being asked to send photographs or images of themselves, or what diabetes means to them. Which will be used as a building block to form a mosaic of 'The Face of Diabetes'. Boxes will be placed in a selection of GP surgeries throughout the UK around World Diabetes Day (14th November) for pictures to be posted alongside any personal thoughts they have on living with diabetes. Images and comments can also be emailed, text or uploaded to the following link: http://www.facingdiabetes.co.uk or posted to Facing Diabetes, Merck Sharp & Dohme Ltd, Hertford Road, Hoddesdon, Hertfordshire, EN11 9BU..
In the last year alone, the UK prevalence of diabetes has significantly increased with over 50,000 newly diagnosed cases. Diabetes now affects over 2,500,000 people in the UK3,4. The long-term consequences of uncontrolled type 2 diabetes are significant, people with type 2 diabetes are more than twice as likely to die prematurely as those without the condition, and one in 10 patients has been hospitalised because of their diabetes in the last 12 months5.
Marc Evans, Consultant Diabetologist, Llandlough Hospital, comments "Diabetes is set to increase. It is predicted that diabetes prevalence will double world-wide, rising to at least 5% by 2010, accounting for 3.07 million people in the UK6. Having type 2 diabetes doubles your risk of developing cardiovascular disease7. More needs to be done to raise the profile of what it means to have diabetes".
MSD are currently sponsoring a Diabetes Experience Survey on Diabetes UK's website: http://www.diabetes.org.uk. The survey aims to find out more about the experiences and views people with Type 2 diabetes have about living with the condition. The survey will run from Wednesday 12 November until 3 December 2008 or until 1,500 online surveys have been completed, whichever the earliest.
About the Diabetes Impact Survey
The Diabetes Impact (Online) Survey, commissioned by Merck & Co., Inc., of Whitehouse Station, NJ, USA, known in many countries as Merck Sharp & Dohme, was developed with a steering panel of world-renowned medical, scientific and clinical professionals in the field of diabetes and includes Professor Anthony Barnett, Diabetologist and Professor of Medicine, University of Birmingham, United Kingdom; Lori Berard, Nurse Manager, Health Sciences Center, Winnipeg, Canada; Professor Stephen Colagiuri, Endocrinologist, University of Sydney, Australia; Professor Dr Ilhan Satman, Diabetologist / Endocrinologist, Istanbul University, Turkey; and Professor Chan Siew Pheng, Endocrinologist, University of Malaya Medical Centre, Kuala Lumpur, Malaysia. The survey was designed to assess issues and barriers related to the care of patients with type 2 diabetes and to better understand how these barriers might impact the overall burden of diabetes. For these findings, 866 healthcare professionals and 607 patients receiving treatment for type 2 diabetes across six countries (Canada, France, Germany, the United Kingdom, India and Mexico) were surveyed.
The Diabetes Impact Survey commissioned by Merck & Co., Inc., known in many countries as Merck Sharp & Dohme, was developed with a steering panel of world-renowned medical, scientific and clinical professionals in the field of diabetes. Key findings include:
- According to the healthcare professionals surveyed, less than 50% of their patients are achieving their target HbA1c goal, a measure of long-term blood glucose control1
- A survey of patients indicated that 40% reported complications associated with their disease2
National Search for 'The Face of Diabetes'
People with diabetes are being asked to send photographs or images of themselves, or what diabetes means to them. Which will be used as a building block to form a mosaic of 'The Face of Diabetes'. Boxes will be placed in a selection of GP surgeries throughout the UK around World Diabetes Day (14th November) for pictures to be posted alongside any personal thoughts they have on living with diabetes. Images and comments can also be emailed, text or uploaded to the following link: http://www.facingdiabetes.co.uk or posted to Facing Diabetes, Merck Sharp & Dohme Ltd, Hertford Road, Hoddesdon, Hertfordshire, EN11 9BU..
In the last year alone, the UK prevalence of diabetes has significantly increased with over 50,000 newly diagnosed cases. Diabetes now affects over 2,500,000 people in the UK3,4. The long-term consequences of uncontrolled type 2 diabetes are significant, people with type 2 diabetes are more than twice as likely to die prematurely as those without the condition, and one in 10 patients has been hospitalised because of their diabetes in the last 12 months5.
Marc Evans, Consultant Diabetologist, Llandlough Hospital, comments "Diabetes is set to increase. It is predicted that diabetes prevalence will double world-wide, rising to at least 5% by 2010, accounting for 3.07 million people in the UK6. Having type 2 diabetes doubles your risk of developing cardiovascular disease7. More needs to be done to raise the profile of what it means to have diabetes".
MSD are currently sponsoring a Diabetes Experience Survey on Diabetes UK's website: http://www.diabetes.org.uk. The survey aims to find out more about the experiences and views people with Type 2 diabetes have about living with the condition. The survey will run from Wednesday 12 November until 3 December 2008 or until 1,500 online surveys have been completed, whichever the earliest.
About the Diabetes Impact Survey
The Diabetes Impact (Online) Survey, commissioned by Merck & Co., Inc., of Whitehouse Station, NJ, USA, known in many countries as Merck Sharp & Dohme, was developed with a steering panel of world-renowned medical, scientific and clinical professionals in the field of diabetes and includes Professor Anthony Barnett, Diabetologist and Professor of Medicine, University of Birmingham, United Kingdom; Lori Berard, Nurse Manager, Health Sciences Center, Winnipeg, Canada; Professor Stephen Colagiuri, Endocrinologist, University of Sydney, Australia; Professor Dr Ilhan Satman, Diabetologist / Endocrinologist, Istanbul University, Turkey; and Professor Chan Siew Pheng, Endocrinologist, University of Malaya Medical Centre, Kuala Lumpur, Malaysia. The survey was designed to assess issues and barriers related to the care of patients with type 2 diabetes and to better understand how these barriers might impact the overall burden of diabetes. For these findings, 866 healthcare professionals and 607 patients receiving treatment for type 2 diabetes across six countries (Canada, France, Germany, the United Kingdom, India and Mexico) were surveyed.
Thursday, November 6, 2008
WAL MART SYRINGE RECALL
WASHINGTON (Reuters) - U.S. health officials warned doctors and patients on Wednesday that Covidien Ltd was recalling nearly half a million single-use syringes that could pose a serious risk to diabetics.
The Food and Drug Administration said the possibly mislabeled ReliOn syringes could lead to patients receiving an insulin overdose of as much as 2.5 times the intended dose, leading to low blood sugar levels and serious health consequences, including death.
During the packaging process, some syringes labeled for use with U-40 insulin were mixed with syringes labeled for use with U-100 insulin.
Wal-Mart Stores Inc sold the syringes at Wal-Mart stores and Sam's Clubs from Aug. 1 until Oct. 8, the FDA said.
Covidien voluntarily recalled the syringes on Oct. 9, asking that any units of the affected product be removed from inventory and placed in quarantine, the agency said.
Wal-Mart posted the recall announcement in Wal-Mart stores and Sam's Clubs, as well as on its website and sent letters to more than 16,500 customers notifying them of the recall.
The FDA said the manufacturer has received one adverse report related to a syringe from the lot numbered 813900.
Consumers and health care professionals who suspect they have the recalled product may contact Covidien at 866-780-5436 or www.relion.com/recall for more information.
The Food and Drug Administration said the possibly mislabeled ReliOn syringes could lead to patients receiving an insulin overdose of as much as 2.5 times the intended dose, leading to low blood sugar levels and serious health consequences, including death.
During the packaging process, some syringes labeled for use with U-40 insulin were mixed with syringes labeled for use with U-100 insulin.
Wal-Mart Stores Inc sold the syringes at Wal-Mart stores and Sam's Clubs from Aug. 1 until Oct. 8, the FDA said.
Covidien voluntarily recalled the syringes on Oct. 9, asking that any units of the affected product be removed from inventory and placed in quarantine, the agency said.
Wal-Mart posted the recall announcement in Wal-Mart stores and Sam's Clubs, as well as on its website and sent letters to more than 16,500 customers notifying them of the recall.
The FDA said the manufacturer has received one adverse report related to a syringe from the lot numbered 813900.
Consumers and health care professionals who suspect they have the recalled product may contact Covidien at 866-780-5436 or www.relion.com/recall for more information.
Tuesday, November 4, 2008
Monday, November 3, 2008
America's tweens* and teens more than doubled their use of type 2 diabetes medications
America's tweens* and teens more than doubled their use of type 2 diabetes medications between 2002 and 2005, with girls between 10 and 14 years of age showing a 166 percent increase. One likely cause: Obesity, which is closely associated with type 2 diabetes.
* Tweens - Children in between the traditional child and teenager stages of development
The finding is included in a study of chronic medication use in children ages 5 to 19 released today in the journal Pediatrics by researchers from the Saint Louis University School of Medicine, pharmacy benefit manager Express Scripts (Nasdaq: ESRX) and the Kansas Health Institute.
In addition to diabetes, the study found that utilization patterns for blood pressure, cholesterol, attention-deficit disorder and attention-deficit/hyperactivity disorder (ADD/ADHD), asthma and depression medications increased at varying levels during the four year period.
"Our study findings indicate that these increased levels of chronic medication use are symptoms of broader underlying issues affecting children today," said Emily R. Cox, Ph.D., RPh, senior director of research at Express Scripts. "These trends are worrisome given that many of these therapies are treating conditions with modifiable risk factors and if not addressed, many of these children will carry these chronic conditions into adulthood."
For example, the use of asthma medications increased 46.5 percent and ADD/ADHD medication use increased 40.4 percent. Cholesterol and blood pressure medications saw a more moderate growth of 15 percent and 1.8 percent, respectively.
Except for asthma medication, older teens age 15-19 years old account for the largest percentage of children taking these medications.
The bad news, according to Donna R. Halloran, M.D., MSPH, assistant professor of pediatrics at Saint Louis University School of Medicine, is that there is more disease, due in large part to the increasing prevalence of childhood obesity.
"Our findings show that childhood obesity not only has long-term health implications, but also impacts children's immediate health," Halloran said.
However, she says, the rise of prescription use also indicates that more children are being diagnosed and doctors are increasingly using medication to treat these conditions.
"Our findings indicate that we, the doctors, are doing a better job of screening children and diagnosing chronic conditions," Halloran said. "A great example of this is blood pressure, where there has been a big push to identify and treat children in need."
In several cases, the rates of growth were dramatically higher among girls than boys. While boys still take more medications for chronic conditions, the gap has become narrower due to these increases.
The huge increase in type 2 diabetes medication use was driven largely by girls who saw a 147 percent increase over the four year period, compared to boys who saw a 39 percent increase in medicine use. Researchers say they cannot explain this pattern, which is not consistent with the patterns of obesity among boys and girls. However, increased physician office visits and therefore screening rates - particularly for females - could be one contributing factor.
Researchers say the greater increase of girls prescribed ADD/ADHD medication (63 percent versus 33 percent) may be attributed to increased efforts by physicians to identify ADHD in females following studies that suggested that inattentive ADHD, which is much less likely to be identified and treated, was more common in girls than boys.
Another example of a higher increase among females was seen in antidepressants where the number of females between 15 and 19 taking the medicine increased by 6.8 percent, while for males in the same age group, utilization declined slightly. This increase in antidepressant use among older teen girls was a striking exception to decreases for boys and girls ages 5 to 9 and boys ages 10 to 14. It also occurred despite a public health advisory released by the Food and Drug Administration in October 2003 regarding antidepressant use by children. Among all children, the prevalence of antidepressant use had been increasing prior to the advisory, after which it decreased.
Unlike the other medications studied, children ages 5 to 9 accounted for the largest increase in the use of asthma controller medication among the three age groups at 67.3 percent as compared to 38.8 percent for the 10 to 14 age group and 34.7 percent for the 15 to 19 age group.
The researchers noted that this exception could be explained by concerns over the long-term side effects of these medications in children and/or greater physician office visits, and therefore greater likelihood of prescribing.
The database used in conducting the study consists of ambulatory administrative pharmacy claims and eligibility information for over 3.5 million commercially insured children enrolled with Express Scripts between 2002 and 2005.
The study is available here.
Express Scripts, Inc. is one of the largest pharmacy benefit management (PBM) companies in North America, providing PBM services to millions of consumers through facilities in 13 states and Canada. Express Scripts serves thousands of client groups, including managed-care organizations, insurance carriers, third-party administrators, employers and union-sponsored benefit plans. Express Scripts is headquartered in St. Louis, Missouri. More information can be found here.
Established in 1836, Saint Louis University School of Medicine has the distinction of awarding the first medical degree west of the Mississippi River. The school educates physicians and biomedical scientists, conducts medical research, and provides health care on a local, national and international level. Research at the school seeks new cures and treatments in five key areas: cancer, liver disease, heart/lung disease, aging and brain disease, and infectious disease.
* Tweens - Children in between the traditional child and teenager stages of development
The finding is included in a study of chronic medication use in children ages 5 to 19 released today in the journal Pediatrics by researchers from the Saint Louis University School of Medicine, pharmacy benefit manager Express Scripts (Nasdaq: ESRX) and the Kansas Health Institute.
In addition to diabetes, the study found that utilization patterns for blood pressure, cholesterol, attention-deficit disorder and attention-deficit/hyperactivity disorder (ADD/ADHD), asthma and depression medications increased at varying levels during the four year period.
"Our study findings indicate that these increased levels of chronic medication use are symptoms of broader underlying issues affecting children today," said Emily R. Cox, Ph.D., RPh, senior director of research at Express Scripts. "These trends are worrisome given that many of these therapies are treating conditions with modifiable risk factors and if not addressed, many of these children will carry these chronic conditions into adulthood."
For example, the use of asthma medications increased 46.5 percent and ADD/ADHD medication use increased 40.4 percent. Cholesterol and blood pressure medications saw a more moderate growth of 15 percent and 1.8 percent, respectively.
Except for asthma medication, older teens age 15-19 years old account for the largest percentage of children taking these medications.
The bad news, according to Donna R. Halloran, M.D., MSPH, assistant professor of pediatrics at Saint Louis University School of Medicine, is that there is more disease, due in large part to the increasing prevalence of childhood obesity.
"Our findings show that childhood obesity not only has long-term health implications, but also impacts children's immediate health," Halloran said.
However, she says, the rise of prescription use also indicates that more children are being diagnosed and doctors are increasingly using medication to treat these conditions.
"Our findings indicate that we, the doctors, are doing a better job of screening children and diagnosing chronic conditions," Halloran said. "A great example of this is blood pressure, where there has been a big push to identify and treat children in need."
In several cases, the rates of growth were dramatically higher among girls than boys. While boys still take more medications for chronic conditions, the gap has become narrower due to these increases.
The huge increase in type 2 diabetes medication use was driven largely by girls who saw a 147 percent increase over the four year period, compared to boys who saw a 39 percent increase in medicine use. Researchers say they cannot explain this pattern, which is not consistent with the patterns of obesity among boys and girls. However, increased physician office visits and therefore screening rates - particularly for females - could be one contributing factor.
Researchers say the greater increase of girls prescribed ADD/ADHD medication (63 percent versus 33 percent) may be attributed to increased efforts by physicians to identify ADHD in females following studies that suggested that inattentive ADHD, which is much less likely to be identified and treated, was more common in girls than boys.
Another example of a higher increase among females was seen in antidepressants where the number of females between 15 and 19 taking the medicine increased by 6.8 percent, while for males in the same age group, utilization declined slightly. This increase in antidepressant use among older teen girls was a striking exception to decreases for boys and girls ages 5 to 9 and boys ages 10 to 14. It also occurred despite a public health advisory released by the Food and Drug Administration in October 2003 regarding antidepressant use by children. Among all children, the prevalence of antidepressant use had been increasing prior to the advisory, after which it decreased.
Unlike the other medications studied, children ages 5 to 9 accounted for the largest increase in the use of asthma controller medication among the three age groups at 67.3 percent as compared to 38.8 percent for the 10 to 14 age group and 34.7 percent for the 15 to 19 age group.
The researchers noted that this exception could be explained by concerns over the long-term side effects of these medications in children and/or greater physician office visits, and therefore greater likelihood of prescribing.
The database used in conducting the study consists of ambulatory administrative pharmacy claims and eligibility information for over 3.5 million commercially insured children enrolled with Express Scripts between 2002 and 2005.
The study is available here.
Express Scripts, Inc. is one of the largest pharmacy benefit management (PBM) companies in North America, providing PBM services to millions of consumers through facilities in 13 states and Canada. Express Scripts serves thousands of client groups, including managed-care organizations, insurance carriers, third-party administrators, employers and union-sponsored benefit plans. Express Scripts is headquartered in St. Louis, Missouri. More information can be found here.
Established in 1836, Saint Louis University School of Medicine has the distinction of awarding the first medical degree west of the Mississippi River. The school educates physicians and biomedical scientists, conducts medical research, and provides health care on a local, national and international level. Research at the school seeks new cures and treatments in five key areas: cancer, liver disease, heart/lung disease, aging and brain disease, and infectious disease.
Saturday, November 1, 2008
Consumer group asks government to ban Avandia
WASHINGTON - The government should ban the diabetes drug Avandia because of a wide variety of life-threatening risks, including heart and liver damage, a consumer group said Thursday.
The consumer group, Public Citizen, filed a petition with the Food and Drug Administration to have Avandia taken off the market.
It was the second setback in as many weeks for the GlaxoSmithKline medication, which at one time had shown great promise in reducing the blood sugar levels of people with Type 2 diabetes. Last week, the American Diabetes Association and a European counterpart jointly released updated treatment guidelines for doctors that pointedly recommended against using Avandia.
"The FDA is in possession of clear, unequivocal evidence that (Avandia) causes a wide variety of toxicities," Public Citizen said in its petition. "Many of these are life-threatening, such as heart attacks, heart failure (and) liver failure."
The FDA said it will "carefully review" the petition, and it continues to monitor Avandia's safety record.
Avandia's heart risks were brought to light two years ago in a medical journal article that reported a 43 percent higher risk of heart attacks among Avandia patients when compared with those taking other diabetes drugs. Although scientists are still debating a link between the drug and heart attacks, concerns about the medical evidence led to stronger warnings.
As a result, Avandia use dropped sharply but about a million U.S. patients still take it.
Public Citizen said its own research found 14 cases of liver failure associated with Avandia, 12 of which led to death. The petition also said Avandia predisposes some patients to eye problems, anemia and bone fractures.
Glaxo, in a statement, said it does not believe Avandia causes liver failure. The company said its own data shows the drug has a good safety record when it comes to liver problems. The company said the data on heart attacks is inconclusive and that Avandia is safe and effective, when used according to directions. Glaxo shares initially fell on the news, but later rose to close at $37.90, up 1.6 percent.
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