Diabetes: Patients Still Face High Out of Pocket Expenses

MedicalResearch.com Interview with:
Dr. Rui Li
Division of Diabetes Translation
Centers for Disease Control and Prevention
Atlanta, GA

MedicalResearch.com: What are the main findings of the study?

Answer: The proportion of people with diabetes facing high out-of-pocket (OOP) burden declined between 2001 and 2011. Although insurance and income related disparities have declined, almost one-fourth of all people with diabetes still face a high out-of-pocket burden.

MedicalResearch.com: Were any of the findings unexpected?

Answer: The change in out-of-pocket burden over this time period had not been studied before. Thus, there was no reason to expect any change. The decline was, in this sense, unexpected.

MedicalResearch.com: What should clinicians and patients take away from your report?

Answer:  Out-of-pocket spending from prescription drugs contributed a large share of the total out-of-pocket spending. Switching from brand name drugs to generic drugs might reduce the out-of-pocket spending because the copayment and coinsurance for generic drugs are much lower than the brand name drugs.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?


  • First, continue to monitor the change of high out-of-pocket burden to inform healthcare decision makers.
  • Second, we observed a reduction in disparity in high out-of-pocket burden associated with insurance status and income level. Future studies could examine whether this reduced disparity in high out-of-pocket burden has indeed reduced disparity in access to health care and in health outcomes across the diabetic subgroups of the overall population aged <65 years.


Changes Over Time in High Out-of-Pocket Health-Care Burden in U.S. Adults With Diabetes, 2001-2011

Diabetes Care published ahead of print March 25, 2014, doi:10.2337/dc13-1997 1935-5548
Rui Li, Lawrence E. Baker, Sundar Shrestha, Ping Zhang, O. Kenrick Duru,

Tony Pearson-Clarke, and Edward W. Gregg