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Insurance providers in Michigan saved more than $76.5 million on diabetes drugs in the first year

A study that compared expenditures for diabetes medications before and after metabolic surgery among patients with diabetes in Michigan has estimated that insurance providers saved more than $76.5 million on diabetes medications in the 360 days following surgery.

In addition to the numerous health benefits associated with metabolic surgery - there is also a financial benefit - a reduction in the cost of prescription medications due to comorbidity remission. For their study, they researcher estimated the cost savings to health insurance providers using the Michigan Value Collaborative claims data registry, a consortium of more than 100 non-federal acute care hospitals in Michigan, to estimate prescription cost savings for diabetes medications among patients undergoing gastric bypass and sleeve gastrectomy between 2015 and 2021.

In total, 760 patients were identified who met the inclusion criteria, 670 (88%) filled an outpatient prescription for an oral medication, 225 (30%) for insulin and 157 (21%) for a glucagon-like peptide-1 receptor agonists in the 120 days pre-surgery. At 360 days post-surgery, 430 of 635 patients with follow-up at 360 days (67.7%) did not fill a prescription for any type of diabetes medication (Figure 1).

Figure 1: Prescription Medication Use for Diabetes Before and After Metabolic SurgeryMultimodal therapy denotes a combination of glucagon-like peptide-1 receptor agonists (GLP-RA), insulin, and oral medications for diabetes (Credit: JAMA Surg. Published online March 01, 2023. doi:10.1001/jamasurg.2022.7749)

They reported that the mean decrease in diabetes prescription payments made by the insurance provider was $4133 per patient ($6736 for gastric bypass and $3409 for sleeve gastrectomy) in the 360 days post-surgery vs. with the 360 days pre-surgery. Approximately 34% of all patients undergoing metabolic surgery in Michigan have diabetes and 54,454 metabolic procedures were performed between 2015 and 2021. Therefore, the researchers estimated that insurance providers in Michigan saved more than $76.5 million on diabetes medications in the 360 days following surgery.

“We found a considerable cost savings resulting from discontinuation of medications for diabetes after metabolic surgery, which only represented prescription activity for 1 year following metabolic surgery and did not account for potential cumulative savings as a result of long-term diabetes remission or downstream cost benefits associated with optimizing diabetes management,” they concluded.. “…Given that fewer than 1% of the eligible population undergo surgical treatment for obesity and metabolic disease in the US and only one-fourth of patients undergoing surgery are diagnosed with diabetes, we believe that there is an opportunity to decrease the financial and medical burden of diabetes.”

The findings were reported in the Research Letter, ‘Financial Impact of Metabolic Surgery on Prescription Diabetes Medications in Michigan’, published in JAMA Surgery. To access this paper, please click here


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