Diabetes Costs Plateau: The Trap Behind the Triumph

The diabetes cost curve just bent. Here's why that's both fantastic and frightening.  
‍We all know healthcare costs only move in one direction—up. Especially with diabetes, which has been devouring employer budgets at twice the rate of everything else. Until now.

Our latest analysis uncovered something the healthcare industry rarely delivers: actual good news. Diabetes costs are finally stabilizing. However, we may need to hold off before we pop the champagne.

‍The Numbers Don't Lie

The financial data shows an unmistakable shift:

• Annual spend for diabetics increased just 11% from 2021-2024, while spend for non-diabetics jumped 15%

• Average monthly medical spend for diabetics decreased slightly (0.5%), while non-diabetic medical spend surged 17%

• Prescription growth for diabetics (34%) stayed well below the 57% spike for non-diabetics

For the first time, diabetic spend is flattening faster than non-diabetic spend—completely reversing the previous pattern where diabetes costs outpaced everything else by 2x.

Three Forces Reshaping the Landscape

This didn't happen by accident. Consider these major market shifts:

• GLP-1 medications work. They enhance insulin sensitivity, reduce insulin requirements, and promote weight loss—attacking multiple diabetes complications simultaneously.

• Big Pharma finally flinched on insulin pricing. After decades of unchecked price increases, the three manufacturers controlling 90% of the insulin market implemented $35 monthly copay caps.

• Smart management programs deliver results. Data-driven diabetes programs reduce hospital admissions by 28% while improving preventive care compliance, addressing the most expensive aspects of diabetes care.

Amidst this positive trend in diabetes spend rests an uncomfortable reality: it may depend on a potentially permanent pharmaceutical commitment. The GLP-1 paradox exists in plain sight—stop the medication, and patients regain most of the weight and complications. As one researcher bluntly stated: "We don't really know how to stop these medicines."

The question isn't whether GLP-1s work—they do. The question is whether your organization is prepared for the long-term implications of this approach to America's diabetes epidemic.

Leverage the Window of Opportunity

This cost plateau creates a brief strategic opportunity. While your competitors debate what to do, you can transform what's historically been a budget liability into a competitive advantage.

• Your standard reports are masking the real story. Are you seeing the complete picture—or just pharmacy invoices? GLP-1 users appear more expensive on paper but deliver where it truly matters. One employer discovered 40% lower medical costs despite 2.5× higher pharmacy spend. Their GLP-1 users had fewer prescriptions for comorbidities and better health markers.  

• Your PBM profits from your blind spots. Are you aware of all available rebates for your Rx spend? While your PBM takes 10% of your drug spend on GLP-1s alone, they're quietly pocketing insulin rebates and price cap savings meant for you. Demand transparency. Implement authorization controls (one PBM blocked 21.5% of inappropriate GLP-1 requests) or explore prescription optimization that can slash GLP-1 costs by 56%.

• Traditional networks profit off your inaction. The diabetes care ecosystem is fragmented by design. Diabetic patients bounce between specialists, emergency rooms, and pharmacies, with each stop multiplying costs. Direct contracting eliminates this inefficiency. Add integrated coaching and reduce diabetes prescription costs by 63% within a year.

The diabetes cost curve is bending—now you decide whether that becomes a sustainable victory or a deeper dependency.  

Nomi Health is invested in partnering with you to change the healthcare landscape. Our Trends in Spend series uses claims analysis to identify crucial patterns in healthcare costs.  This report analyzed diabetes-related spending across employer health plans from 2021-2024.

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