New calculator demonstrates how improved adherence to anti-diabetic medicines can benefit people in Medicaid

Reid Porter
Reid Porter May 25, 2023

New calculator demonstrates how improved adherence to anti-diabetic medicines can benefit people in Medicaid.

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Diabetes is a scary diagnosis for anyone. When people with the disease struggle to manage their blood sugar levels, they can experience significant, life-threatening and costly complications such as heart attack, stroke, kidney failure, amputation and blindness. Fortunately, diabetes can be well-managed with comprehensive access to health care services, including medicines.

To that end, PhRMA recently partnered with GlobalData to demonstrate how, when people with diabetes enrolled in Medicaid are not able to adhere to their treatment regimen, it affects their health outcomes. The tool GlobalData created — known as the Medicaid Diabetes Adherence Online Tool — demonstrates how states can avoid costly medical complications if adherence to anti-diabetic medicines is improved over six years. Specifically, the tool provides analyses that show differences in the impacts diabetes has on various communities, as well as opportunities to improve health equity and reduce health costs, by race, ethnicity and age.

The new tool is being shared with the goal of helping policymakers and health care professionals to find ways to improve adherence to anti-diabetic medication among Medicaid beneficiaries. The following statistics highlight areas to be addressed:

While diabetes is a chronic condition that can be managed, the burden of the disease falls disproportionately on communities of color.

  • Diabetes disproportionately affects American Indians/Alaska Natives (14.7%), Hispanics (12.5%) and non-Hispanic Blacks (11.7%) compared to White populations. Communities of color are also more likely to experience complications from diabetes. The rate of diabetes-related deaths among Native Americans/Alaska Native populations is 2.3 times higher than non-Hispanic Whites, and Hispanics are 1.3 times more likely to die from diabetes than non-Hispanic Whites.

  • Communities of color are also less likely to receive recommended diabetes preventive care, such as hemoglobin A1c (HbA1c) testing, annual cholesterol screening and retinal examination.

Because so many people with diabetes are covered by Medicaid, access to care through Medicaid plays an important role in helping individuals manage their disease.

Despite the low cost of medicines in Medicaid, enrollees take their medication as prescribed only about 75% of the time.

  • Medicines in Medicaid have limited cost sharing from $1-$4, and rebates from manufacturers help to offset costs for states and the federal government. Despite these limited costs, some enrollees continue to face access barriers.


The new Medicaid Diabetes Adherence Calculator provides a visual comparison across 50 states and Washington, D.C. To use the tool, click here. For more information about Medicaid, please visit www.PhRMA.org/Medicaid. See more resources geared toward policy solutions in all 50 states at www.PhRMA.org/States.

Topics: Diabetes, Adherence, Medicaid