Opportunities for Cost Reduction of Medical Care: Part 3

Monte Malach; William J. Baumol

Disclosures

J Community Health. 2012;37(4):888-896. 

In This Article

Endocrinology

The increase in obesity in the United States, where 30% of adults and children are now obese, is directly related to excessive food intake, glucose intolerance, endogenous insulin deficiency, and diabetes in 20% of the population.[55] The resulting, obesity-related diabetes epidemic is also very expensive. The diabetes rate has doubled worldwide over the past 30 years, and the Centers for Disease Control have reported that 26 million Americans have diabetes and 76 million are pre-diabetic.[56] Clearly early detection and treatment of diabetes and pre-diabetes would improve health and help to reduce the costs of medical care.

The use of Avandia® (rosiglitazone) to treat diabetes has a multitude of coronary-related side effects, including very serious ones—like ACS and AMI.[57] Better dietary control and standard therapy with older and cheaper drugs, such as metformin, continue to be effective.

An inexpensive, older drug, Bacillus Calmette Guérin®—commonly used as a prophylaxis against tuberculosis, also can be very effective for diabetes treatment. It has been shown to resuscitate deficient pancreatic functioning to secrete insulin,[58] though it costs just $15 per vial. The drug is reported to reverse the immune inactivation of the pancreatic production of insulin and has the potential to provide blockbuster savings for the treatment of diabetes.

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