Financial Burden for Patients With Type 2 Diabetes Higher Than Those Without

Investigators found that patients with type 2 diabetes could face more financial burden compared with patients without diabetes. They state that a patient’s financial health should be considered for treatment of type 2 diabetes, according to the results of a study published in JAMA Network Open.¹

In a study, investigators say that a patient’s financial health should be considered when starting treatment for type 2 diabetes. | Image Credit: Sherry Young - stock.adobe.com

“The data show that patients with diabetes who had debt in collections and delinquent debt had significantly higher dollar amounts of debt than those without diabetes, as well as significantly lower credit scores,” the study authors wrote.¹ “Patients with diabetes were more likely to experience 2 of the 7 financial outcomes compared with 1.2 outcomes of patients without diabetes.”

In 2022, the total estimated cost of diagnosed diabetes was $412.9 billion in the US, including $306.6 billion for direct medical costs and $106.3 billion for indirect costs. Additionally, patients with diabetes incur, on average, $19,736 in annual medical expenditures, with $12,022 being attributed to diabetes. On average, patients with diabetes have medical expenditures 2.6 times higher than patients without diabetes, according to the American Diabetes Association.²

In another study published in Diabetes Therapy, pharmacists can help to lower the cost of diabetes care with the use of pharmacist-led interventions. Investigators found that there were consistent findings that showed diabetes management with a pharmacist involved was cost-effective or even saved costs when compared to the standard of care, despite variations in the cost of these interventions. They believe that it is attributed to better glycemic control, better compliance, and reduced risk of medication-related issues.³

In the current study, investigators assessed the association of type 2 diabetes with financial outcomes, specifically below-prime credit scores, medical and other debt, delinquent debt, debt charge-offs, bankruptcy filing, and foreclosures. Data from electronic health records were used, including glycemic hemoglobin measures, diagnosis of type 2 diabetes, or antidiabetic medication prescribed between October 1, 2017, and December 31, 2021. Credit data were from a major US credit bureau that had information from approximately 95% of the adult population in Ohio. Credit types, account balances, overdue payments, and more were included.¹

The sample included 166,285 patients, with a mean age of 52.3 years and 55% being female. Approximately 0.2% were American Indian, Alaskan Native, Native Hawaiian, or Pacific Islander; 3.5% were Asian; 19.1% were Black; 73.2% were white; and 0.8% were multiracial. Further, approximately 2.1% were Hispanic. A total of 69,371 patients had type 2 diabetes. Approximately 50.8% lacked earned income and 32.6% had Medicare. Patients with diabetes were older, more often male, and more often Black compared with those without diabetes.¹

During the study, approximately 56.1% had adverse financial outcomes, including 51.7% who had below-prime credit scores, 32.2% who had debt in nonmedical spending, 29.2% who had debt in medical spending, 18.5% who had overdue debt, 12.1% who had debt charge-offs, 1.7% who filed for bankruptcy, and 0.4% who had foreclosure. Patients with diabetes had greater adverse financial outcomes (63.5%) compared with those without diabetes (50.7%). There was greater exposure to all adverse financial outcomes for patients with diabetes, with higher estimated probabilities for any financial outcome at 64.5%, below-prime credit score at 59.7%, medical spending at 36.9%, nonmedical spending at 38.4%, delinquent debt at 23.3%, debt charge-offs at 15.4%, bankruptcy filings at 2.1%, and foreclosures at 0.5% compared with those without diabetes.¹

Patients younger than 65 years with diabetes were more likely to have adverse financial outcomes than those without diabetes at 71.5% and 44.3%, respectively. Female patients with diabetes also had higher probabilities of adverse financial outcomes compared with male patients (65.9% and 62.2%, respectively), and Black patients had higher probabilities compared with white patients with diabetes at 87.3% and 59.4%, respectively. Furthermore, Hispanic patients with diabetes also had a higher probability of adverse financial outcomes compared with patients who were nonHispanic, at 74.8% and 64%, respectively.¹

“Directions for future research are to examine how financial hardships are associated with the progression of type 2 diabetes and disability-related complications, with a particular focus on heterogeneity by socioeconomic characteristics,” the study authors wrote.¹

REFERENCES

1. Pesavento M, Loibl C, Moulton S, et al. Type 2 Diabetes and Financial Outcomes. JAMA Netw Open. 2025;8(7):e2523453. Published 2025 Jul 1. doi:10.1001/jamanetworkopen.2025.23453

2. Parker ED, Lin J, Mahoney T, et al. Economic Costs of Diabetes in the U.S. in 2022. Diabetes Care. 2024;47(1):26-43. doi:10.2337/dci23-0085

3. Zhu J, Zhou Y, Wang G. Cost-Effectiveness of Pharmacist Care in Diabetes Management: A Systematic Review. Diabetes Ther. 2024;15(1):61-76. doi:10.1007/s13300-023-01505-2