Impact of type 2 diabetes mellitus on prescription medication burden and out-of-pocket healthcare expenses

Diabetes Res Clin Pract. 2010 Mar;87(3):360-5. doi: 10.1016/j.diabres.2009.11.021. Epub 2010 Jan 4.


Aims: The number of prescription medications and out-of-pocket expenses of individuals with type 2 diabetes mellitus (T2DM) were evaluated to assess the economic burden of diabetes.

Methods: The self-reported number of prescription medications and out-of-pocket healthcare expenses were evaluated from respondents of the United States SHIELD study with and without a diagnosis of T2DM. Medications included monotherapy and combination therapy; combination tablets were counted as one agent. Analysis of variance and multivariate linear regression models adjusted for age, gender, prescription insurance coverage, and household income.

Results: Of the T2DM respondents (n=3551), 40% were on 1 prescription antidiabetic agent (7% insulin alone), 26% were on 2 agents, 8% were on >or=3 agents, with a mean of 1.3 antidiabetic agents. After adjusting for age, gender, insurance coverage, and income, respondents with T2DM had a significantly larger total number of prescriptions (6.2) and higher out-of-pocket expenses for both annual medical ($1158) and monthly prescription ($144) expenses, compared with respondents without T2DM (n=8686) (4.1 prescriptions, $925 annual medical, $118 monthly prescription) (p<0.01).

Conclusions: Increased out-of-pocket medical and medication costs in T2DM are due to the use of both antidiabetic agents and other medications for treatment of comorbid conditions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetes Mellitus, Type 2 / economics*
  • Female
  • Financing, Personal / economics*
  • Health Expenditures
  • Health Surveys
  • Humans
  • Hypoglycemic Agents / economics*
  • Hypoglycemic Agents / therapeutic use
  • Insurance, Health / economics
  • Insurance, Pharmaceutical Services / economics
  • Male
  • Middle Aged
  • Prescription Drugs / economics*
  • Prescription Fees*
  • Surveys and Questionnaires


  • Hypoglycemic Agents
  • Prescription Drugs