Latest diabetic medications more costly, but users have fewer hospital visits

Diabetics who were prescribed newer medications to control their illness were more likely to take these drugs as instructed than were other patients who were prescribed drugs that have been on the market for several decades.

A new study suggests that patients on the newer medications had a slightly lower risk of hospitalization because of diabetes-related complications. They also spent between $920 and $1,760 less on annual total healthcare costs.

The researchers analyzed more than three years' worth of medical records' data on patients who took thiazolidinediones (TZDs) or either metformin or a sulfonylurea to control their diabetes.

TZDs (pioglitazone and rosiglitazone, brand names Actos and Avandia, respectively), were approved by the Food and Drug Administration in the late 1990s. Metformin and sulfonylureas have been on the market for more than 50 years.

"Taking a TZD as instructed was the strongest predictor of a reduced risk of hospitalization and decreased healthcare costs in this group of patients," said Rajesh Balkrishnan, the study's lead author and the Merrell Dow professor of pharmacy at Ohio State University.

The issue is that TZDs can be 10 times more expensive than the older diabetes drugs, Balkrishnan said.

"There are a lot of new medications on the market for treating diabetes," Balkrishnan said. "Although some of these newer drugs are more expensive, that extra expense is made up for by a reduction of cost in other aspects of healthcare use."

The study appears in a recent issue of the journal Current Medical Research and Opinion.

The researchers collected information on 3,191 adults enrolled in the North Carolina Medicaid program, which covers all medical and prescription costs of its enrollees. All of the participants had Type 2 diabetes and started medications for the disease between July 2001 and December 2003.

The enrollees were divided into two groups based on the type of drug their physicians prescribed: 1,774 took a TZD, while 1,417 took either metformin or a sulfonylurea. The researchers collected information on total healthcare expenditures and hospitalization rates for all patients through December 2004.

A person with Type 2 diabetes is insulin resistant, meaning that the cells in his body can't correctly use the insulin it makes; as a result, blood sugar levels remain high. TZDs make cells in the body more sensitive to insulin, while metformin lowers blood sugar levels and sulfonylureas boost pancreatic insulin production.

Metformin and the sulfonylureas are available in generic forms. A generic medication contains the same ingredients and has the same effect on the body as its brand-name counterpart, but typically sells for much less. The pharmaceutical companies that make TZDs still hold the patents for these drugs, so generic versions aren't yet available.