Medicare coverage for Afrezza increases 2% nationally

[mnholdem]

Medicare coverage for Afrezza (see Table 2) continued to increase another 2% since March 1st and has now grown to 11% unrestricted access for lives covered under Medicare plans. That may not seem like much, but it's a significant number of Medicare patients.

See updated tables in the Formulary Tracker located in the Afrezza Script Counts & Other Metrics forum (available for members only).

mnkd.proboards.com/thread/3729/formulary-tracker-plan-coverage-afrezza

 

[Deleted]

Are there estimates as to how many medicare patients have diabetes?

[mnholdem]

From a report in 2006:

The prevalence of diabetes in the U.S. Medicare population is growing at an alarming rate. From 1980 to 2004, the number of people aged 65 or older with diagnosed diabetes increased from 2.3 million to 5.8 million. According to the Centers for Medicare and Medicaid (CMS), 32% of Medicare spending is attributed to the diabetes population.

Source: www.ncbi.nlm.nih.gov/pmc/articles/PMC1484724/

A more recent abstract filed with the American Diabetes Association:

For the Medicare-eligible population, the diabetes population is expected to rise from 8.2 million in 2009 to 14.6 million in 2034; associated spending is estimated to rise from $45 billion to $171 billion.

Source: care.diabetesjournals.org/content/32/12/2225

[slugworth008]

Apr 14, 2017 9:02:53 GMT -5 @reverselo said:

Are there estimates as to how many medicare patients have diabetes?

  Two words "Google It". Most likely there are but I'm lazy today.

[markado]

Based on the 2009 ADA projection for 2034, if the increase is linear, then each year adds approx. 256,000 PWD'S per year. That equates to an increase of 2M since 2009.

[mango]

Diabetes affects more than 25 percent of Americans aged 65 or older[1] and its prevalence is projected to increase approximately 2 fold for all U.S. adults (ages 18-79) by 2050 if current trends continue.[2] We estimate that Medicare will spend $42 billion more in the single year of 2016 on fee-for-service, non-dual eligible, over age 65 beneficiaries with diabetes than it would spend if those beneficiaries did not have diabetes -- $20 billion more for Part A, $17 billion more for Part B, and $5 billion more for Part D. On a per-beneficiary basis, this disparity is just as clear. In 2016 alone, Medicare will spend an estimated $1,500 more on Part D prescription drugs, $3,100 more for hospital and facility services, and $2,700 more in physician and other clinical services for those with diabetes than those without diabetes.[3] Fortunately, type 2 diabetes is typically preventable with appropriate lifestyle changes.

The Medicare Diabetes Prevention Program (MDPP) expansion was announced in early 2016, when the Secretary of Health and Human Services determined that Diabetes Prevention Program model test met the statutory criteria for expansion. The final rule establishing the expansion was finalized in the Calendar Year 2017 Medicare Physician Fee Schedule (PFS) Final Rule published in November 2016.

Medicare Diabetes Prevention Program (MDPP) Expanded Model

[matt]

Just remember to separate the Type II diabetics, the majority of which are not insulin dependent, from the Type I and Type II diabetics who are. Frequently you will see the numbers presented in the medical and epidemiological literature in abbreviated form as NIDDM and IDDM for Non-insulin-dependent diabetes mellitus and Insulin-dependent diabetes mellitus, respectively.