Preventing, Managing Diabetes Through A Holistic Approach

More people today are living with diabetes than ever before. According to the Centers for Disease Control, about 1 in 10 Americans have diabetes and more than 1 in 3 have prediabetes.

Diabetes and related acute and long-term complications result in serious health conditions and represent a significant, costly burden on the healthcare system with $1 out of every $4 in U.S. healthcare spent on caring for people with diabetes, including an annual total of $15 billion spent on insulin alone.

Out-of-pocket costs for insulin can be a major expense—regardless of insurance status or coverage type.

In fact, over the last two decades, insulin costs have increased 600%, creating an extraordinary financial barrier for a vulnerable population whose ability to access the prescription drug can be the difference between life and death. And among the 8 million Americans who rely on insulin to live, a 2019 JAMA Internal Medicine article found that 1 in 4 insulin users report skipping or skimping on prescribed dosages due to the high cost of the drug.

CareFirst BlueCross BlueShield (CareFirst) is advancing a multi-pronged approach to help drive down costs associated with diabetes care and promote preventative healthcare measures for individuals living with diabetes. Through advocacy and partnerships, community support, and preventative care solutions, CareFirst continues to expand access to affordable, equitable and high-quality care for all.

Advocacy & Partnerships

The U.S. represents only 15% of the global insulin market, but generates nearly 50% of the industry’s insulin revenue, with the most used forms of insulin costing 10 times more in the United States than in any other developed country.

In March 2022, the U.S. House of Representatives voted to approve The Affordable Insulin Now Act—legislation that would limit cost sharing for insulin under private health insurance and Medicare at either $35 a month or 25% of an insurance plan’s negotiated price.

Earlier this year, CareFirst joined Civica’s Affordable Insulin Initiative along with CivicaScript, The Civica Foundation and 12 independent Blue Cross Blue Shield companies to make insulin more affordable and accessible to those who rely on insulin. Civica’s Affordable Insulin Initiative will produce three insulins expected to be available to all consumers for $30 or less per vial beginning in 2024.

Community Support

CareFirst supports the health and wellbeing of the communities it serves by leveraging resources and investing in programs addressing social determinants of health. In addition to funding solutions that promote healthcare access and quality, CareFirst recognizes the importance of improving the environments where people live, learn, work and play.

“Inequities in economic and environmental conditions have a negative impact on the health and behavioral outcomes associated with diabetes prevention and control,” said Brian D. Pieninck, President and CEO of CareFirst. “We must work side-by-side with local partners to improve the factors that contribute to the prevalence of diseases like diabetes and lessen the effect they have on quality of life.”

Throughout 2022, CareFirst issued $1.71 million in grant investments to combat the diabetes epidemic. 26 local organizations and health coalitions working in historically marginalized communities received funds to promote economic inclusion and educational opportunity in addition to removing barriers to behavioral health and accessible, affordable, high-quality care to address the root causes of diabetes.

Preventative Care Measures

CareFirst’s “Whole Person, Whole Health” approach to managing diabetes ensures medical, physical and emotional needs are all met and addressed. Coupled with advocacy and community investments, CareFirst offers a variety of enhanced benefits and programs to improve access and quality of care for members with diabetes and communities at risk. These include $0 cost share on insulin and diabetes supplies, personalized counseling and coaching, online tools and virtual care, and educational materials, among others.

“The best way to fight pre-diabetes and type 2 diabetes, which are the most common types, is to avoid them in the first place,” said Dr. Tich Changamire, Chief Medical Officer of CareFirst. “Developing health nutrition and physical activity habits are critical factors in avoiding diabetes.”

By meeting members wherever they are on the continuum of health, developing and maintaining a comprehensive set of resources and facilitating tailored touch points and solutions for those in need of care, diabetes can be successfully and safely prevented and managed.