Diabetes drug displays lined the San Diego Convention Center hallway during June's American Diabetes Association meeting here. June 11, 2017. Cheryl Clark, inewsource.
Diabetes drug displays lined the San Diego Convention Center hallway during June's American Diabetes Association meeting here. June 11, 2017. Cheryl Clark, inewsource.

The pharma exhibits at the American Diabetes Association conference here last month stretched across the San Diego Convention Center floor like a mile of drugs.

Displays for Tresiba, Invokana and Victoza, to name just a few, conveyed the largesse of an industry that is skyrocketing by any measure: dollar cost per unit, the number of people purchasing them and the number of prescriptions sold.

[one_half][box type=”shadow this-matters”]Some 86 million Americans live with prediabetes, which can progress to diabetes, a costly and debilitating disease. A new program can help people lose weight, a proven way to reduce the risk of getting the disease.[/box][/one_half]

With $51.5 billion in U.S. sales in 2016 alone, diabetes drugs had the highest amount of revenue in the nation, above drugs to treat cancer and autoimmune disease, according to QuintilesIMS, which analyzes information from drug companies and suppliers.

Some 29 million people with diabetes across the country take drugs to control glucose. Costs among the 136 brand name drugs soared* from $15.9 billion in sales in 2009 to $32.2 billion in 2014.

Among the 136 top brands analyzed, the drug with the largest revenue increase in 2014 is a pen that delivers doses of insulin by injection, sold as Lantus Solostar. Wholesale sales were up 525 percent from $714.8 million in 2009 to $4.46 billion in 2014.

According to the American Diabetes Association, insulin drug prices overall rose three-fold between 2002 and 2013.

“Insulin prices have skyrocketed,” said Pat VandenHeuvel of San Diego, whose 22-year-old son, William, needs those drugs for his Type 1 diabetes, a genetic form of the disease. For example, their insurance plan now charges $410 as a co-pay for a 20-day supply of one brand of insulin pens, up from about $350 a year ago.

Januvia, another top selling diabetes drug called a DPP-inhibitor, which is taken by oral tablets, increased from $1.53 billion in 2009 to $3.46 billion in 2014, or 126 percent.

Another Lantus insulin pen product was the third largest selling diabetes drug, with $1.9 billion in 2009 sales, growing to $3.4 billion in 2014, a 78 percent increase.

Medicare, which pays for care for some 55 million people, most of them 65 and older, is especially concerned about the cost of treating diabetes and its complications.

That’s because the agency spent $42 billion more in 2016 for services for Medicare beneficiaries with diabetes than for those that did not have diabetes. That included $5 billion for pharmaceuticals to treat diabetes. Per beneficiary, that’s $1,500 more on Part D prescription drugs, $3,100 more for hospital and other services, and $2,700 more on physician and other clinical services the agency said.

It isn’t just the cost of drugs that’s been increasing, but also the number of prescriptions.  Between 2012 and 2016, the number of prescriptions for diabetes drugs rose from 186 million to 224 million in the U.S., a 20 percent increase. (That 2016 number may actually be higher, because an increasing number of prescriptions are being filled for a 90 day-supply instead of for 30 days.)

According to Quintiles, the “largest drivers” of growth in prescription sales were the increasing number of seniors who are more likely to have health problems requiring drug treatment.

These massive increases are a major reason Medicare officials want to prevent people from getting diabetes in the first place. Starting Jan. 1, it plans to roll out a program, described in an inewsource story June 29, that pays qualifying organizations up to $450 if participants stick to attendance in a year-long lifestyle program with 22 classes and lose 9 percent of their body weight within the year, and $425 if they lose 5 percent.

*The amount does not include reductions in prices due to coupons, discounts, rebates or promotions.

More in the series …

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[one_third]Oscar and Teri Lara shop for fresh food more frequently in their quest to lose weight and avoid diabetes. June 27, 2017. Megan Wood/inewsource[/one_third]

[two_third_last]Medicare to pay $450 to help seniors lose weight, avoid diabetes
June 29, 2017
Some 86 million Americans live with prediabetes, which can progress to diabetes, a costly and debilitating disease. A new program can help people lose weight, a proven way to reduce the risk of getting the disease.[/two_third_last]

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[one_third]Diabetes drug displays lined the San Diego Convention Center hallway during June's American Diabetes Association meeting here. June 11, 2017. Cheryl Clark, inewsource.[/one_third]

[two_third_last]Spending on diabetes drugs is ‘skyrocketing’
July 5, 2017
The largesse of a the drug industry related to diabetes is skyrocketing by any measure: dollar cost per unit, the number of people purchasing them and the number of prescriptions sold.[/two_third_last]

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[one_third]Photo courtesy Michael Stern, Flickr Creative Commons[/one_third]

[two_third_last]Medicare boosts incentives to promote weight loss, prevent diabetes
July 17, 2017
Participating providers — from hospital systems and physician groups to wellness centers, supermarket chains and even churches — could receive up to $785 for each participant who loses 5 percent of their body weight.[/two_third_last]

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[one_third]Research involving the diabetes drug Invokana shows a doubled rate of leg, foot and toe amputations in patients. (Megan Wood/inewsource)[/one_third]

[two_third_last]Doctors debate danger of popular diabetes drug after FDA amputation warning
August 31, 2017
Many San Diego doctors are taking their patients off of Invokana, a widely used diabetes drug, after a large industry-sponsored trial found it doubled the risk of lower limb amputations compared with those taking a placebo.[/two_third_last]

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[one_third]Physician models of feet help people with diabetes understand the impact of the disease on blood flow to their lower limbs. (Megan Wood, inewsource)[/one_third]

[two_third_last]Diabetes-related amputations up significantly in California — and San Diego
Sept. 20, 2017
Clinicians are amputating more toes, legs, ankles and feet of patients with diabetes in California — and San Diego County in particular — in a “shocking” trend that has mystified diabetes experts here and across the country.[/two_third_last]

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[one_third]Screen Shot 2017-09-20 at 11.48.35 AM[/one_third]

[two_third_last]Diabetes-related amputations: How we crunched the data
Sept. 20, 2017
To identify the increase in diabetes-related amputations in California, inewsource analyzed data from the California Office of Statewide Health Planning and Development, the agency that collects information about the care provided to patients discharged from California hospitals.[/two_third_last]

Cheryl Clark is a contributing healthcare reporter at inewsource. To contact her with questions, tips or corrections, email clarkcheryl@inewsource.org.