Diabetes Medication Cost

Typical costs:

• For patients not covered by health insurance, diabetes medication costs $4 to $100 per month for metformin, the most commonly prescribed and recommended first-line diabetes drug for patients who have been unable to achieve target glucose levels with diet and exercise. The price of generic metformin would be at the lower end of the range, while a brand name such as Glucophage or Glucophage XR would be on the higher end.
• For patients without health insurance, diabetes medication costs $8 to $200 per month or more for metformin taken along with another diabetes drug, such as one of a class of medications called sulfonylureas -- such as brand name Glucotrol or Diabinese -- or one of a class of drugs called alpha-glucosidase inhibitors, such as brand names Precose and Glyset. It is common for a doctor, if metformin alone does not control blood glucose sufficiently, to add another drug.
• For patients without health insurance, diabetes medication costs $200 to $500 or more a month for a multi-drug regimen that could include other classes of oral medications, including newer medications such as the brand name Januvia, or injectable medications such as the brand name Byetta. If first-line medications do not achieve target blood glucose levels, or if the patient cannot tolerate the side effects, or if certain drugs are contraindicated for a patient for reasons such as heart disease or other illnesses, a doctor might try other medications, often in combinations. Doctors often will take cost into account when prescribing medications if the patient requests it.
• The Mayo Clinic[1] has a cost comparison chart for diabetes medications.
• Diabetes medications are covered by most health insurance plans because they are considered medically necessary. Medicare generally covers diabetes medications. The American Diabetes Association[2] has a guide to Medicare and diabetes prescription drug benefits.
• For patients covered by insurance, typical out-of-pocket costs consist of a prescription drug copay ranging from $10 to $50, depending on the drug. If the patient takes multiple drugs, copays can total $200 a month or more.

• There are five classes of oral medications typically used to treat diabetes in the United States today, and doctors sometimes prescribe a combination of different drugs. In addition, two new injectables have been introduced. The American Diabetes Association[3] offers an overview of diabetes medications.
• Biguanides -- such as the brand name Glucophage -- causes the liver to produce less glucose and aids in the absorption of glucose by muscle tissue. It usually is taken twice a day; a common side effect, digestive upset, is lessened by taking it with food.
• Sonfonylureas -- examples include the brand names Diabinese, Glucotrol and Diabeta -- cause cells in the pancreas to release more insulin. These drugs usually are taken once or twice a day before meals; they all have similar effects on glucose levels but have different side effects and interactions with other drugs.
• Meglitinides -- examples include the brand names Prandin and Starlix -- also cause cells in the pancreas to release insulin, and usually are taken three times a day before meals; some can have interactions with alcohol.
• Thiazolidinediones -- brand names Avandia and ACTOS -- facilitate the work of insulin in muscle and fat and also cause the liver to make less glucose. One drug in this class, Rezulin, was taken off the market because it caused liver problems in some patients, and these drugs might also increase risk of heart problems.
• Alpha-glucosidase inhibitors -- Precose and Glyset -- block breakdown of starches and sugars in the intestines. They are taken at the beginning of each meal and can cause gas and diarrhea. A new type of inhibitor, a DPP-4 Inhibitor -- brand name Januvia -- also can lower cholesterol. The two new injectables, brand names Symlin and Byetta, both are synthetic hormones that are injected with meals. They tend not to cause hypoglycemia or weight gain but both can cause nausea.

• Diabetes management involves regular doctor visits and home test strips used to monitor blood sugar levels.

• Or, to save money, the American Diabetes Association recommends asking your doctor to prescribe a higher-dose pill -- for example, 500 mg instead of 250 mg -- and using a pill splitter to get the correct dose; consult a pharmacist, though, since some extended-release medications are not suitable for splitting.
• For patients without health insurance, many drug manufacturers provide free or discounted medications through patient assistance programs. Or, the Partnership for Prescription Assistance[4] can offer help to patients who qualify.

• Your general practitioner can help manage your diabetes and advise you on which medications might work for you; it is important to take into consideration how the medications work, how often they are taken and what side-effects they have as well as interactions with any other medications you take. The American Academy of Family Physicians[5] provides guidelines for choosing a family doctor. Or, a board-certified internal medicine doctor can serve as your primary care provider; the American Board of Internal Medicine[6] offers a doctor search feature.
• Diabetes medications do not work for all patients; they are most likely to work well for those diagnosed with diabetes less than 10 years ago, and who do not take high doses of insulin.
• Oral diabetes medications should not be used by women who are pregnant or breastfeeding; in this case, only insulin, diet and exercise are recommended. Each drug has different risks, so discuss these with your doctor.

1.  www.mayoclinic.com/health/diabetes-treatment/DA00089
2.  www.diabetes.org/living-with-diabetes/treatment-and-care/health-insurance-options/...
3.  www.diabetes.org/living-with-diabetes/treatment-and-care/medication/
4.  www.pparx.org
5.  familydoctor.org/familydoctor/en/healthcare-management/working-with-your-doctor/ch...
6.  www.abim.org/

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