As people with type 2 diabetes age into the Medicare program, there’s the potential for more not to stick with treatment and/or to experience complications from the disease, a new study shows. The report was published Tuesday in JAMA Network Open.
Researchers evaluated data from 129,997 people who were 65 or when they started utilizing Medicare. When people enrolled in Medicare, quarterly out-of-pocket costs for diabetes drugs went up by $23.04 on average. The increase in costs at age 65 years was about $56 in the 95th percentile of spenders. Investigators attributed some of this increase to changes in drug utilization, which shifted between classes when people began using Medicare. The utilization of diabetes drugs went down at age 65, when there were 5.3% fewer claims per quarter, but there was increased insulin use, which led to more patient cost increases.
What was behind the spending increases? The changes in coverage, the authors wrote. Before age 65 years, the majority of insured people had commercial plans with out-of-pocket maximums and no coverage gaps, unlike Medicare Part D.
“These findings suggest that an increase in spending upon reaching age 65 years was associated with increased cost sharing in the coverage gap and catastrophic coverage phases of Medicare Part D, and likely resulted in worse adherence, worse [type 2 diabetes] management and increased T2D complications,” the authors wrote.
The authors warned about the increased incidence of not complying with treatment as well as diabetes complications when people began using Medicare. The higher out-of-pocket costs were a big concern, especially for people with low-income and those in other marginalized groups, which were more likely to experience nonadherence, diabetes complications and death, the authors wrote.
