Authors: Gabriela Fenton Mindy Paulet
Diabetes affects 38.4 million people in the US, with an additional 97.6 million living with pre-diabetes.1 This reality is prompting many organizations, like yours, to explore ways to support employees in managing diabetes while controlling healthcare costs.
Diabetes isn't just a personal health challenge — it's also a growing financial concern for employers. The Centers for Disease Control and Prevention (CDC) estimates that 11.6% of the US population has been diagnosed with diabetes, and another 22.8% of adults remain undiagnosed. Among those living with type 2 diabetes (T2D), 89% are likely to experience at least two other chronic conditions.2
From an economic standpoint, the costs are staggering. According to the American Diabetes Association (ADA), the financial burden of diabetes increased by 4.3% since 2017, reaching $412.9 billion. As a result, diabetes management now accounts for 25% of US healthcare spending. On average, individuals diagnosed with diabetes have medical expenses 2.6 times higher than those without diabetes.3
Driving forces of diabetes
Obesity is the most significant risk factor for both the development and progression of T2D. Currently, at least one in five adults in the US is living with obesity. For those living with T2D, weight loss can improve insulin sensitivity, reducing the need for medications.4 Supporting employees on this journey can improve their health and decrease costs over time.
Certain populations are at higher risk of developing diabetes and experiencing more complications.5 Research shows that ethnic minority groups and individuals from lower socioeconomic backgrounds face higher risks, along with higher mortality rates. Additionally, research from the National Institute of Diabetes and Digestive and Kidney Diseases reveals that among a national sample of US adults with diabetes, more than 30% experience food insecurity, and more than one in every six are both food insecure and have low diet quality.
Balancing care and costs
Given the significant personal and financial impact of diabetes, many employers are raising an important question: How can employers best support their employees in an integrated way while also managing the cost of diabetes care?
The ADA recommends glucagon-like peptide 1 agonists (GLP-1) as the preferred second-line treatment for T2D after metformin. GLP-1s are frequently selected for their advantages in managing blood sugar levels and improving cardiovascular health outcomes. However, GLP-1s are more expensive than older T2D treatments, driving up pharmacy costs and increasing the pharmacy spend in the diabetes therapeutic class.6, 7
How employers can support employees with diabetes
Managing diabetes in the workplace isn't just about offering health coverage — it's about taking a proactive, integrated approach. Analyzing claims and gaps in care related to diabetes is essential for optimizing diabetes management and preventive strategies. Effective programs should strike a balance between controlling costs and supporting employees to take control of their health.
With new tools and innovative solutions emerging, organizations have a unique opportunity to engage with employees/members while driving cost efficiencies. A comprehensive strategy should focus on reducing barriers, minimizing the need for medications, promoting a healthier lifestyle, stabilizing blood sugar levels, closing gaps in care and providing ongoing support.
Consider these 10 actions for a more effective diabetes management strategy:
- Review your medical and pharmacy claims more closely to identify high-cost trends and eliminate gaps in care.
- Evaluate your pharmacy benefit manager (PBM) contract to ensure alignment with cost-effectiveness and innovative diabetes solutions.
- Enhance virtual care and digital health options to include prescription management care oversight and member engagement.
- Simplify access to testing and glucose management tools to reduce barriers in treatment through plan design.
- Align diabetes solutions with your business goals and people strategies.
- Check workplace policies to ensure they support employees living with diabetes.
- Assess social determinants of health, such as food insecurity, and include solutions through targeted programs.
- Provide coverage for mental health and oral care.
- Launch detection strategies for uncovering undiagnosed employees/members.
- Focus on preventive care and health promotion strategies.
A unique opportunity for employers
With the rise in diabetes cases and associated costs, employers are in a unique position to make a meaningful impact. Partnering with Gallagher's consulting team can result in a well-structured employee benefits plan, innovative disease management programs, and the prioritization of cost-effective formularies. Our goal is to help employers control healthcare costs, improve employee health outcomes and enhance overall wellbeing.
Gallagher is here to help you drive decisions and strategies that are aligned with your business and business goals. Contact your Gallagher consultant today to learn more about helping your organization support employees with diabetes.
