Not surprisingly, insulin prices play a big part in this increase, growing 53% in the last five years. But less expected is a significant rise in prices for non-insulin diabetes medications. Prices for this category of drugs have increased by 76%, driven mostly by expensive brand-name medications such as Byetta and Trulicity.

This analysis is based on a new list price index created by GoodRx researchers to track prescription drug prices in the United States. The index takes into account published list prices as set by drug manufacturers and the prescription drug mix as dispensed by community retail pharmacies. The list price index is a powerful indicator of drug pricing trends, especially when looking at the treatment costs for specific conditions and the populations most vulnerable to them.

The analysis on diabetes list prices tells us two things: Medication prices are definitely on the rise, year over year, and diabetes patients are feeling it at least twice as much as the average patient.

By comparing the index value for all conditions against the index value for one specific condition, we can see which patients are more exposed to climbing drug prices. Diabetes treatment prices are shown to have increased at double the rate of treatments for all conditions since 2014—a significant rise of 56% in the last five years.

This comes as no surprise: For years, insulin has been the poster child for drug price hikes. The diabetes price index also corroborates other research showing insulin prices have been increasing steadily over the years and may continue to do so indefinitely. But, as it turns out, insulin isn’t the only diabetes treatment we should be watching out for.

To investigate the true cost of having diabetes, we broke the diabetes price index down even further by separating it into three different categories: insulins, non-insulin diabetes medications, and diabetes medical supplies (glucose meters and test strips). We found that insulin isn’t the only type of treatment that diabetes patients are forced to spend more on.

Here are 4 main takeaways:

1. Insulin prices have increased by more than 50% since 2014, mirroring the overall pricing trend for all diabetes products. 30.3 million Americans now have diabetes, and both type 1 and type 2 diabetes patients use insulin to process glucose from food. With popular insulins like Humalog and Lantus costing north of $300 per vial, sick Americans who can’t afford their insulin (regardless of whether they have health insurance or not) are resorting to risky “quick fixes” like rationing doses or crowdfunding their next prescription fill.

2. Non-insulin diabetes medications are 75% more expensive than they were five years ago, their prices having increased at a higher rate than insulin prices. Different kinds of non-insulin medications are prescribed to type 2 diabetes patients to help improve their blood sugar control and/or insulin sensitivity at different stages of their condition. Expensive brand-name drugs, such as Bydureon, Victoza, and Januvia, are typically prescribed to type 2 diabetes patients with an A1C value higher than 9% and have trouble managing their condition with lifestyle changes and metformin (available as a cheap generic) alone.

3. Though prices for diabetes medical supplies have stayed relatively flat, there has still been a 15% increase over the last five years – more than twice the rate of inflation. But retail prices for glucose meters and test strips remain high enough for there to be a grey market. This is another example of high prices driving patients to unorthodox measures to get the treatment they need.

4. 2019 has been a year of price hikes so far. While it’s no secret that drug manufacturers increase the list prices of their medications every January, the prices for insulins, non-insulin diabetes drugs, and overall treatments all jumped like clockwork at the beginning of 2019, after all having stayed relatively flat the previous six months, possibly due to the pressure of the national conversation surrounding high drug prices.

The GoodRx List Price Index

What is the list price?

The list price is the official price of a drug, set by its manufacturer. In reality, few patients actually pay a drug’s list price, as the price of a drug goes through several transactions in the distribution chain before a patient sees it at the pharmacy counter.

One such transaction making recent headlines is the common practice of drug manufacturers providing rebates to pharmacy benefit managers (PBMs), which may keep list prices high. High list prices can mean more of those costs are passed on to the patient.

What is the prescription drug mix?

Every pharmacy dispenses a different combination of brand-name and generic drugs, depending on the population it serves. This is what we call the “drug mix.” The GoodRx list price index uses a nationally representative sample of prescription fills from each quarter to estimate the drug mix across all community retail pharmacies for that time period.

The drug mix is used to calculate the average price change of all drugs and is updated every quarter. Shifts in the drug mix, like new drugs going to market and decreased utilization of an expensive brand-name drug, can affect total and average prescription drug spend.

GoodRx list price index methodology

The list price index is calculated daily, taking into account day-to-day changes in list prices and quarterly changes in the prescription drug mix. Since the index is based on the drug mix as dispensed by pharmacies, price changes in high volume and high-cost drugs will have more impact on the index than changes in low-volume and low-cost drugs.

The list price index starts on December 31, 2013, using the Q4 2013 drug mix and published list prices on December 31, 2013. The base of the index is set to 100 on December 31, 2013. For example, an index value equal to 125 indicates an increase in drug prices of 25% since December 31, 2013.

Co-contributors: Jeroen van Meijgaard, PhD and Clement B. Feyt, MPH

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