Posted at 3:01 a.m., Tuesday, June 19, 2007
12 percent of U.S. health budget spent on diabetes
Associated Press
The U.S. government spends 12 percent of its health budget on diabetes care, spread across at least 18 agencies, according to the first report to add up the disease's costs throughout the government.The $79.7 billion spent on treating diabetes and its complications in fiscal 2005 exceeded the entire budget of the Education Department, said authors of a study commissioned by Novo Nordisk A/S, the world's biggest maker of insulin for diabetics. The report urged lawmakers to better coordinate efforts and shift spending toward prevention by screening patients most at risk.
The number of Americans with diabetes has doubled to 21 million since 1980, and the number of cases is expected to rise because of sedentary lifestyles and poor eating habits. Too many patients have been relying on drugs alone to treat the disease, some doctors said, although that may change since Avandia, GlaxoSmithKline Plc's top-selling diabetes medicine, was linked to heart risks.
"It's easier to prescribe a pill than educate people to change their eating habits and to check that they're reaching their target blood sugar levels," said Richard Hellman, a Kansas City doctor and the president of the American Association of Clinical Endocrinologists, in a telephone interview yesterday. "That's not a good strategy."
Treatment costs, preventative care and drug safety will be debated at American Diabetes Association's annual science conference beginning June 22 in Chicago.
Avandia was the world's most popular diabetes pill last year, with $3.3 billion in sales. Doctors have written fewer prescriptions for the drug since a May 21 analysis in the New England Journal of Medicine indicated that it raised the risk of heart attacks by 43 percent. London-based Glaxo said longer- range studies don't show the same dangers, and regulators say patients should consult their physicians before changing treatment.
Most diabetes cases are type 2, a form linked to age, obesity and lack of exercise. The cells of these patients don't properly use the hormone insulin to turn blood sugar into energy, and high blood sugar over time can harm nerves and blood vessels. If untreated, diabetes can lead to blindness, kidney failure, amputation or even death.
Researchers supported by Novo Nordisk, based in Bagsvaerd, Denmark, found spending on diabetes treatment was spread across 18 of 21 U.S. agencies studied.
"Virtually every department in the federal government with the probable exception of three — the Department of State, the Department of Energy and the General Services Administration — has some form of policy or program responsibility that could contribute to achieving federal diabetes goals," the study's authors wrote.
Dana Haza, senior director of Novo Nordisk's diabetes advocacy program, called for appointment of a "national diabetes coordinator." The official would oversee efforts that affect diabetes patients in programs such as the Medicare and Medicaid health plans, education services and food stamps for the poor.
The government spent $3.9 billion on prevention and health- promotion related to diabetes in the fiscal year ended Sept. 30, 2005, compared with the almost $80 billion for treatment, according to the report.
The increasing prevalence of diabetes, combined with high costs associated with hospitalization from complications and life-long medicine bills, has some doctors worried about how long the current trends can continue.
"At the rate diabetes is growing, this will bankrupt the American health-care system, there's no doubt in my mind," said Larry Deeb, a doctor in Tallahassee, Florida, and the president of medicine and science for the American Diabetes Association, in a phone interview yesterday.
