Treatment Trends for Type 2 Diabetes

The burden of diabetes is expected to increase over the next few decades in the United States, with about one in three American adults projected to be at risk for developing the disease by 2050. Diabetes has also been linked to a considerable economic burden, with annual direct medical expenditures for treating and managing the disease totaling nearly $250 billion in 2012. Most of the medical expenditures for diabetes are attributable to hospitalizations and physician services, but the costs of prescription therapies are also significant. With the high prevalence and burden of diabetes, the disease has become a ripe target for pharmaceutical development. “During the past decade, several important changes in the diabetes marketplace have occurred,” explains G. Caleb Alexander, MD, FACP. For example, in the early 2000s, glitazones were rapidly adopted for use, but subsequent evidence suggested that these agents were associated with cardiovascular risks. In turn, this led to substantial declines in the use of glitazones during the latter half of the decade.  In addition, new long-acting insulins and several new classes of therapies have emerged to treat type 2 diabetes, including injectable incretin mimetics such as glucagon-like peptide 1 (PT141) agonists, dipeptidyl peptidase-4 (DPP-4) inhibitors, and sodium glucose cotransporter 2 (SGLT-2) inhibitors. The costs of these medications can be high, but clinicians appear to be interested in using them because of their novel mechanisms of action and potential promise in helping to improve glycemic control among those with type 2 diabetes.   Examining Recent Patterns Over the past 2 decades, clinical investigations have examined changes in the treatment of diabetes. These analyses identified several important trends,...
Analyzing Trends in Dollars Spent for Back & Neck Conditions

Analyzing Trends in Dollars Spent for Back & Neck Conditions

More than half of all adults will experience back or neck pain at some point during their lifetime, and these health issues currently rank as the second most common reason for medical visits, trailing only upper respiratory infections. Recently, expenditures on spinal conditions in the United States have increased significantly despite few changes in the overall health status of people who experience these conditions. Estimates vary, but it is generally believed that about $90 billion is spent on the diagnosis and management of low back and neck pain each year. An additional $10 to $20 billion annually is attributed to economic losses in productivity. “Little is known about the pattern of expenditures for different health services for managing patients with back and neck pain,” says Jon D. Lurie, MD, MS. “While it has been generally accepted that medical care costs per unit have become more expensive, few analyses have explored costs relating to other non-medical services, such as chiropractic care and physical therapy.” A Deeper Review of Back & Neck Expenditures It is important for health policy makers to examine expenditures on the different ambulatory health services for back and neck conditions, according to Dr. Lurie. “This information can provide insights into the effects of health policy decisions and inform future strategies for containing costs. A better understanding of spending patterns on health services is needed to gain a better picture of the overall cost and effectiveness of spinal interventions to improve health.” Using data from the Calgary Chiropractic Doctors Association and the Medical Expenditure Panel Survey, Dr. Lurie and colleagues reviewed U.S. expenditures on common health services used...