Medical Expenditures Associated With Diabetes Among Privately Insured U.S. Youth in 2007

OBJECTIVE: To estimate, among privately insured youth in the U.S., medical expenditures associated with diabetes and the difference in medical expenditures between individuals with insulin-treated diabetes mellitus (ITDM) and with non-ITDM (NITDM). RESEARCH DESIGN AND METHODS: Using the 2007 MarketScan commercial claims and encounter database, we analyzed data for 49,356 youth (aged ≤19 years) who were continuously enrolled in fee-for-service health plans. Youth with diabetes (cases) were identified from inpatient, outpatient, and pharmaceutical drug claims. Each case was matched with five controls (without diabetes) by age (±2 years), sex, census region, and urban versus rural residence. We used regression models to estimate medical expenditures in total and by component (inpatient, outpatient, and medication). RESULTS: The predicted mean annual total per-person medical expenditures were $9,061 for youth with diabetes and $1,468 for those without, an excess of $7,593 for those with diabetes; of which, 43% was for prescription drugs. The predicted mean annual total expenditures were $9,333 for ITDM youth and $5,683 for NITDM youth, respectively, an excess of $3,650 for those with ITDM diabetes, of which 59% was for prescription drugs. CONCLUSIONS: The excess medical expenditures associated with diabetes, ITDM in particular, among youth are substantial. Our estimates of excess expenditures can be used to assess the economic burden of diabetes overall and by diabetes treatment mode. Our estimated excess expenditure for NITDM may be used for evaluating the economic efficiency of interventions aimed at preventing type 2 diabetes in U.S. youth.