Individuals who adhere to their diabetes medications have an associated 31% lower hospitalization risk

March 27, 2018

What was the study about?

This study followed more than 15,000 individuals with a diabetes medical claim for one year. The goal was to look at hospitalization rates, and medical and pharmacy costs. It compares the costs of the diabetes-drug adherent and nonadherent members. 

Previous studies on adherence to diabetes medications had focused on more limited populations – a single employer or a retiree population. 

What did we learn?

Three-fourths of the members in the study were adherent to their medications; one-fourth were nonadherent. Those adhering to medications were found to have an associated 31 percent lower risk of hospitalization and lower medical costs ($1,010) than the nonadherent group. 


Researchers from Prime reviewed pharmacy and medical claims from a commercial medical plan with 1.3 million members. The study criteria included:

  • Continuous enrollment between 2007 and 2009 
  • Two separate office visits for diabetes or a diabetes-related hospitalization in 2008
  • A diabetes medication supply or a diagnosis of diabetes with microvascular disaease

All medical and pharmacy claim costs were added up to determine the total cost of care. A total of 15,000 members fit the criteria and were followed for one year. 


Of the group followed, 74 percent were adherent to their medication. 26 percent were nonadherent. 

Annual total cost of care for adherent members in the study was $11,777; of that, $4,699 were pharmacy costs. Total cost of care for nonadherent members was $11,206, of that, $3,117 represented pharmacy costs. Although pharmacy costs were higher, the annual medical costs were $1,010 less in the adherent group at $7,079, compared to $8,089 in the nonadherent group.

Total one year cost of care by diabetes medication adherence

Total one year cost of care by diabetes medication adherence


The study found an association between adherence to diabetes medications and risk of hospitalization. This is consistent with previous research. Individuals with diabetes who adhere to their medication had an associated one-third lower risk of hospitalization when compared to patients who do not adhere to their medication. 

Until now, there has been little data quantifying the potential value of improved outcomes with better medication adherence in a large commercially insured population. 

This study is one of the largest of its kind.

What does this mean for you?

Adherence to diabetes medications is associated with a lower risk of hospitalization and lower medical costs. This is good news: This can mean improved health outcomes for your employees who stay adherent to their diabetes medications.  

This study also suggests that there is not a medical cost offset to increased adherence. 

To understand this, it’s helpful to look at the pharmacy spend landscape: Diabetes drugs are expensive. They are the largest single component of drug spend (14.1 percent in 2017).2 The costs of diabetes drugs have been rising very quickly. 

When you focus on improving adherence for members with diabetes, focus first on members with coexisting cardiovascular (heart) conditions. Adherence may help them reduce adverse medical events. GuidedHealth® has targeted, outreach and adherence programs.


  1. Statistics about Diabetes. American Diabetes Association.
  2. Spring 2018 Prime Drug Trend Report. Accessed at:

GuidedHealth is a registered trademark of Prime Therapeutics of LLC.

Diabetes Medication Adherence Association with Hospitalizations and Total Cost of Care (Spring 2011)

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