Diabetes disproportionately impacts minority populations in the United States. In particular, Hispanics are almost twice as likely as non-Hispanic whites to be diagnosed with diabetes and have higher rates of end-stage renal disease (ESRD) due to diabetes. We analyzed data from the Medicare 5% sample file by race/ethnicity for type 1 (T1D) and type 2 diabetes (T2D) to determine the economic burden of ESRD.
For the years 2012-13 we identified 1,397,933 enrollees from the publicly-available Medicare 5% sample > 65 years without Medicare Advantage coverage (HMO).
The prevalence of T1D was 2.0% and 21.9% for T2D. ESRD affected 5.4% of the T1D and 1.9% of T2D populations. Rates of ESRD were significantly higher for other races for both T1D and T2D compared to whites.
Comparing costs, allowed amount (claims less discounts/ineligible charges) for treating ESRD was higher for T1D Hispanics than T1D whites ($8,946 vs. $8,332 per member/month, P<0.001). In contrast to other races, T2D Hispanics with ESRD were not more costly than whites ($6,634 vs. $6,542). Similar results were seen for net paid costs taking into account cost-sharing. Average cost-sharing for all patients with ESRD was $730 (no diabetes), $1,177 (T1D) and $939 (T2D) per member/month respectively.
In conclusion, the burden of ESRD due to T1D and T2D and the associated cost for T1D with ESRD were higher for Hispanics than for white Medicare enrollees.
N.M. Glantz: Research Support; Self; Eli Lilly and Company. I. Duncan: Consultant; Self; Eli Lilly and Company. T. Ahmed: None. D. Kerr: Advisory Panel; Self; Glooko, Inc.. Research Support; Self; Eli Lilly and Company. Speaker's Bureau; Self; Sanofi-Aventis. Stock/Shareholder; Self; Cellnovo. Advisory Panel; Self; Novo Nordisk Inc..