Author's Perspective: During one of my workshops, one of the audience members asked me: "What is the cost of your book?"
I said: "Well, the value of the book is easily a couple hundred thousand dollars."
Several of the audience members gasped but a few of the audience members laughed, because they understood what I said.
Then, I said: "Just to clarify: the book is worth $200,00 but you can buy it for just $24.95."
Most of the audience laughed because they realized that $24.95 is a small price to pay to avoid blindness, amputation, kidney dialysis or a heart attack.
And, yet, some diabetics thought that $24.95 was too much to pay for a book!
Although I disagree with this thinking, I do understand the issue: Spending $24.95 in the present seems a lot more expensive than trying to save $200,000 in the future.
That's one of the reasons why I put part of my program on my website -- so that people couldn't use money as an excuse for not trying the program.
Also, there are people who may have just lost their job or are having some serious financial problems, so $24.95 is a lot of money to spend right now.
However, I would be remiss if I didn't take the time to explain the real cost of being diabetic that goes far beyond $24.95.
The Real Cost of Being Diabetic
The real cost for being diabetic includes a much lesser quality of life that many diabetics don't see coming. It's difficult to imagine your life without your eyesight or your legs -- until it happens.
I can't tell you the number of people who wished that they could go back in time and spend the $24.95 and make the small changes to their diet and lifestyle.
But, instead, now they have to live with not being able to see, not being able to walk, or having to get around in a wheelchair.
In addition, they have to deal with the emotional issues, family problems, problems with their partner, problems at work, not being able to work, a very stressful life, and even more financial problems.
The cost for being diabetic is three-fold:
There is the cost to you on a physical and personal level that cannot be measured in dollars and cents – the quality of life lost when the disease is not controlled, the effort it takes to maintain a healthy lifestyle, and the stress and emotional issues associated with living with the disease and the associated physical disabilities. Refer to the Impact of Diabetes on You web page for more details.
There is also the actual cost in dollars and cents – as in the costs for medications, surgeries, hospital stays, diabetic supplies, doctor visits/exams, and even commerce lost because of the debilitating nature of the disease.
And, there is the cost to your family and loved ones -- financially and emotionally.
Financial Costs for Being Diabetic
So, what is the real (financial) cost of being and remaining diabetic?
If the disease is not managed correctly, the cost can be tremendous; and, far more than you may realize. Most diabetics are shocked when they discover how much they have to spend out-of-pocket because healthcare coverage is steadily going down and being passed onto the patient.
Four of the biggest factors contributing to rising diabetes costs are the costs for insurance, hospital stays, medications, and supplies.
Health insurance costs are not only rising, but the insurance is no longer covering what it used to cover!
Hospital stays are rising almost exponentially while the insurance coverage keeps going down!
Costs for medications and supplies continue to rise despite the ever-growing revenues and profits of the cold and money-hungry pharmaceutical companies.
The cost for diabetic supplies alone can be tremendous. Testing for blood glucose levels can cost up to $0.93 per test, and for those who have to test their glucose levels 4-6 times a day, this can add up very quickly.
Costs are also skyrocketing for surgeries, hospital testing and home care.
All of these expenses are due to your diabetes being uncontrolled or poorly controlled resulting in major medical expenses for kidney dialysis, eye surgery, cardiovascular surgery, dental work, and amputations.
And, don't expect Social Security, Medicare or Medicaid to bail you out! These programs are running out of money and cover less than the private insurance programs!
Fortunately, there are many wellness programs out there that can help you prevent this damage and the associated costs from destroying your life financially (and emotionally).
For example, the Death to Diabetes Wellness Program is one of the more comprehensive and effective programs in the United States that can help you. As long as you are willing to take some action: call, send an email, do something -- but, don't wait until you're in the hospital!
In addition, diabetics can defray some of the cost by getting their testing supplies for free or at a much lower cost, even if they are currently insured or on government assistance programs like Medicaide and Medicare.
Most of these programs will work directly with the insurance company to figure out the lowest-cost avenue for the patient, and to present these options to the patient in an easy to understand and helpful manner.
Many diabetics will adjust their lives to cope with the lesser quality of life, physical impairment, emotional issues, and a stressful life. But, unless you're rich, it's difficult to overcome the financial impact of being diabetic -- even though you may be doing fine today. Five years ago there were diabetics just like you who were doing fine financially -- until they lost their job or ended up in the hospital.
Based on several recent studies (published in the Diabetes Care journal and the New England Journal of Medicine) people diagnosed with diabetes spend over $4,100 more each year on medical costs than people who don't have diabetes.
This cost gap is increasing substantially each year following the initial diagnosis, as the various diabetic complications settle in -- leading to more drugs, more doctor appointments, more doctors, more specialists, more hospital visits, and more surgeries.
If you have very good health insurance, you may not feel the full brunt of being diabetic, but, health insurance premiums are also rising.
In addition, other medically-related costs are also rising, including the costs for drugs, doctor visits, hospital stays, kidney dialysis, dental care, surgeries, post-op care, home care, rehab care, services for the blind, services for amputees, etc.
Also, the health insurance is no longer providing the same level of coverage. The health coverage is being reduced due to rising medical costs.
Unfortunately, many diabetics are shocked to discover when they're in the hospital, or having surgery, or getting additional medical tests, that their health insurance coverage has been reduced or has certain financial limitations!
But, by then, it's too late. It's not a coincidence that medical debt is the Number 1 cause for bankruptcy in the United States.
And, by the way, medical debit is also the Number 1 cause for losing your home. Believe it or not, many of us are only one major hospital visit/surgery and post-op care from going bankrupt or losing our home.
Many people with diabetes are unaware of the financial impact and how much it's really costing them to be diabetic and what it's going to cost them in the future to remain diabetic.
Even if you're doing okay right now, eventually, you will either have to increase your insurance premium payment to cover what is covered today, add some form of supplemental insurance coverage, or lower your payment because you can't afford the increased costs, or, you may have to cancel your insurance.
And, don't make the mistake and rely on the government's Medicare or Medicaide program! All they're going to do is give you the cheapest drugs possible and wait for you to expire!
Examples of Diabetic Costs
Here are some of the costs associated with being diabetic, or for having any illness. Unless otherwise noted, these are monthly costs that are continuing to rise annually.
- Insurance premium: $50-$150
- 1-2 Diabetic drugs: $5-$15
- 1-2 High blood pressure drugs: $5-$15
- 1 Cholesterol statin drug: $5
- 1-4 Other prescription drugs: $5-$15
- 1-2 OTC drugs: $2-$5
- Glucose test strips: $10--$50
- Testing supplies (i.e. lancets, alcohol wipes, cleaning supplies): $10-$15
- Insulin needles/syringes, other supplies:: $15-$25
- Kidney dialysis: $0-$50 per session
- Primary Care Doctor appointments: $25-$150 per visit
- Physical Exam: $50-$150 once a year
- Blood Tests: $25-$75 every 6 months
- Endocrinologist appointments: $75-$175 per visit
- Ophthalmologist appointments: $75-$100 per visit
- Podiatrist appointments: $75-$100 per visit
- Dentist appointments: $75-$100 per visit
- Other Doctor specialists (i.e. kidneys, heart, nerves, etc.): $75-$175 per visit
- Diabetes educator, Dietitian/Nutritionist: $10-$25 per visit
- Diabetes classes: $0-$50 for a 10-week class
- Home Care Provider: $50-$100 per visit or monthly
- Hospital Visits: $2500-$20,000 per visit
- Surgeries: $25,000-$50,000 per surgery
- Post-op Care: $15,000-$50,000/year
- Vitamin/mineral supplements: $10-$25
On average for most people, it's costing anywhere from $75 to $300 a month to be diabetic; and, in some cases, as much as $600 a month, especially if there have been any extended hospital stays or surgeries.
But, please keep in mind that these are average numbers spread out across many months. In reality, most people usually have costs at the lower end; and, then, there is a major health crisis that lands you in the hospital for an extended stay that may cost anywhere from $20,000 to $50,000!
Now, if you have the extra savings, this may not seem like a serious financial crisis as you read this right now, but $600 a month over a 20-year period of time invested at 5% or in a half-decent mutual fund is a nice chunk of change!
How would you like to have an extra quarter of a million dollars?! That's right -- $250,000! Don't believe me? Just ask Suze Orman (she's a financial guru) or use an online financial calculator such as:
If the financial costs don't scare you, then, think about the diabetic complications and the physical impact and what it would be like to live without your eyesight or to live without one or both of your legs or to rely on a wheelchair to get around.
The Cost for Eating Healthy
On the surface it appears that eating healthy is a lot more expensive than eating lots of processed foods and fast foods. After all, foods such as wild salmon and extra virgin olive oil are expensive!
However, we fail to take into account that we avoided or dramatically reduced the expenses for prescription medications, doctor appointments, hospital visits, extra medical insurance, etc.
So, even if you spend more money a month for healthy foods, you'll save thousands of dollars from hospital stays and surgeries!
In addition, we fail to realize that there are some healthy foods that are very inexpensive, such as beans, most vegetables, and most fruits.
We also fail to realize that some of the more expensive foods can be very unhealthy such as meat, especially beef.
So, if you reduce the amount of meat that you buy each week, or stop eating meat once or twice a week, you'll be pleasantly surprised how much money you can save on your grocery bill!
Other cost-saving tips include: buying in bulk, using your freezer to stock up on good deals, gardening to growing a few herbs or vegetables, and menu planning.
Although studies show that junk food and fast food tend to cost less than fruits, vegetables and other healthy foods, the cost doesn't take into account the medical bills associated with eating those fast foods and junk foods! Studies show that people who eat junk food and fast food are more likely to develop diabetes, heart disease, obesity, arthritis, and other similar illnesses.
Other Web Links About Rising Costs
Here are some (external) web links that discuss the rising costs of diabetes and the cost to you for being diabetic:
Cost of Medications
As diabetes care becomes more intensive and complex, the use of medications does as well. Patients with diabetes are often on a mixture of diabetes medications, plus other drugs for common associated conditions, i.e. high blood pressure, high cholesterol.
As a result, more than 67% of diabetics take at least 3 different medications, while some take as many as 8-12 different medications! And, it's not getting any better! Some diabetics may be spending less per drug, but they're taking more drugs!
These trends are encouraged by studies such as the United Kingdom Prospective Diabetes Study (UKPDS), which endorsed not only complex treatments for hyperglycemia, but also the aggressive addition of anti-hypertensive medications, when necessary, for diabetic patients. Published guidelines for care also endorse such trends.
Cost is an issue that has not been emphasized but is an inherent concern as medication use becomes more complex. How expensive are complex treatment regimens for patients? What percentage of patients in a region or area have a pharmacy benefits plan or insurance coverage for medications? To what degree does the cost of medications affect the prescribing physicians when patients do have insurance coverage for their drugs?
The Burden of Drug Costs
Overall, drug costs have become a substantial and rising part of total health care costs. For example, Medicaid recently announced that the cost of prescription drugs exceeded the cost of physician services. The same is true for commercial health plans.
No doubt the same pattern is true for diabetes drugs; however, this issue has not been documented completely. The last available national estimate of drug and supply costs for diabetes care was by Huse and colleagues.
They calculated that the average annual national patient expenditures in the late 1980s for insulin, syringes, and self-testing equipment and supplies for glucose measurements was $0.9 billion. However, this and other contemporaneous estimates did not account for medications for related conditions, such as hypertension and hyperlipidemia.
In addition, the oral hypoglycemic medications available at that time cost much less than the drugs that have become available since. Therefore, similar estimates today may prove to be much higher, and the inclusion of medication for related disorders would substantially increase the costs.
To make matters worse, these cost estimates do not take into account the rising costs for test strips, hospital stays, surgeries, and hospice care -- due to the impact of the various complications of diabetes, i.e. blindness, amputation, kidney dialysis, dental care, heart attack, stroke.
Current Medication Use by Diabetic Patients
A recent survey about medication use and cost of 128 patients (75 women, 53 men) found that the average patient took between 4 and 5 medications per day. Of these, 3–4 of the medications were for the treatment of diabetes, hypertension, or hyperlipidemia. The monthly cost of these drugs ranged from $80 to $115.
These estimates did not include the cost of syringes or home glucose monitoring supplies. These two items increased monthly drug costs by at least $55. Thus, the total estimated monthly drug cost for these patients ranged between $115 and $170.
How to Reduce Your Cost
But, even if you're diabetic or have some other illness, you can reduce the associated medical costs! Many diabetics are unaware of the financial savings associated with spending a few dollars on a book, ebook, or DVD to help them reduce the rising costs of being diabetic!
And, even if you don't have the money, you can still implement the first 3 steps of our program (free of charge). This will get you going in the right direction and actually allow you to save some money on your grocery bill and maybe your medications.
Then, you can use your savings to get the book and implement the rest of the program so that you can reap all the savings and other benefits.
But, the bottom-line is that the patient must be more cognizant of the cost for being diabetic, including the hidden costs -- and, take action to avoid the rising medical costs -- or, pay the price for not being aware of the real financial cost for being diabetic.
Cost of Diabetes Treatment Nearly Doubled Since 2001
Because of the increased number of patients, growing reliance on multiple medications and the shift toward more expensive new medicines, the annual cost of diabetes drugs nearly doubled in only six years, rising from $6.7 billion in 2001 to $12.5 billion in 2007 according to a study in the Oct. 27, 2008, issue of the Archives of Internal Medicine.
Since more then one-tenth of all health care expenditures in the United States in 2002 were attributable to diabetes, this finding raises important questions about whether the higher cost actually translates into improved care.
Researchers found that the number of Americans diagnosed with diabetes rose steadily from 10 million in 1994, to 14 million in 2000, to 19 million in 2007, and almost 30 million in 2016.
This rapid growth reflects trends in American eating habits and behavior, the authors note, since the risk of developing type 2 diabetes increases with age, obesity, and physical inactivity. Part of the increase is due to an increasingly sedentary lifestyle and increasing caloric intake.
At the same time, the average number of medications per patient has increased from 1.06 medications per patient in 1994 to 1.45 medications per patient in 2007. In 1994, 82 percent of patients were prescribed only one drug; in 2007, only 47 percent were.
Meanwhile, the average price of a diabetes drug prescription increased from $56 in 2001 to $76 in 2007, due in large part to the rapid uptake of newly available oral medications, increasingly prescribed as alternatives to injectable insulin.
In 2007, for example, new drugs such as sitagliptin (brand name Januvia, $160 per average prescription) and exenatide (Byetta, $202) made up eight percent and four percent, respectively, of all physician office visits where a diabetes drug was prescribed. These drugs cost eight to 11 times more than older, generic drugs such as metformin or glypizide.
Although insulin use declined, the price per insulin prescription increased as new and pricier preparations of long-acting and ultrashort-acting insulins and their combinations gained popularity.
Annual Medical Costs
People diagnosed with diabetes spend $4,100 to $7,500 more each year on medical costs than people who don't have diabetes, a gap that increases substantially each year following the initial diagnosis, according to a study published in the journal Diabetes Care.
And, the medical costs go up an additional $925 to $1739 every year thereafter, over and above the amount they would increase due to aging-related increases in medical expenses. In some cases, for people dealing with multiple health issues, this cost can easily skyrocket to more than $10,000 a year!
Most of the increase can be attributed to the cost of diabetes-related complications, such as heart and kidney disease.
As you read this, the costs may not seem substantial, but, we have met very few people with diabetes who have told us that they budgeted properly for their diabetes expenses. And, if they did, they discovered that they grossly underestimated the long term costs.
The following PowerPoint presentations slides (from one of the author's training programs) provide an overview of the financial impact that diabetes has on a person with diabetes.
Family Healthcare Costs by Treatment
The first diagram (the pie chart) shows that the average cost of a family having someone with diabetes is $13,243 a year. Although most of this may be covered by insurance, these costs will continue to rise while insurance coverage will continue to go down.
Healthcare Costs in U.S.
This second diagram (a bar chart) shows that healthcare costs are rising dramatically and will continue to rise, doubling almost every 10 years.
Healthcare and Out-of-Pocket Expenses
This third diagram (a bar chart) shows that as healthcare costs rise each year, the out-of-pocket expenses to you are also rising, but at a much faster rate.
For example, initially your out-of-pocket expenses may be less than 10% of your annual healthcare costs; but, within several years, that percentage can go up as much as 25% of your annual healthcare costs. That may not seem like much, but if you take int account that your healthcare costs will also rise, then, this increase can be devastating.
As you can see, it's not difficult to see how someone can end up in bankruptcy or lose their home ...
- UK Prospective Diabetes Study Group: Glycemic control with diet, sulfonylurea, metformin, or insulin in patients with type 2 diabetes: progressive requirement for multiple therapies (UKPDS 49). JAMA 281:205-12, 1999.
- UK Prospective Diabetes Study Group: Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes (UKPDS 38). Brit Med J 317:703-13, 1998.
- American Diabetes Association: Clinical Practice Recommendations 1999. Diabetes Care 22 (Suppl. 1):S1-114, 1999.
- Lagnado L: Drug costs can leave elderly a grim choice: pills or other needs. Wall Street Journal, Nov. 17, 1998.
- Tanoiwye E: Drug dependency—U.S. has developed an expensive habit: now, how to pay for it? Wall Street Journal, Nov. 16, 1998.
- Huse DN, Oster G, Killen AR et al: The economic costs of non-insulin-dependent diabetes mellitus. JAMA 262:2708-13, 1989.
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