Strategies for addressing the cost of nonadherence in diabetes.

Diabetes accounts for the second largest amount of avoidable healthcare costs in the United States-an estimated $24.6 billion in wasteful and avoidable spending. Diabetes is a lifelong disease that is highly dependent on patient self-management. Unfortunately, studies demonstrate that almost 50% of patients with diabetes fail to reach the glycemic goal of glycated hemoglobin <7%. Patient nonadherence poses a significant barrier to effective management of diabetes and can place a significant burden on the patient and the healthcare system, resulting in even greater increases in costs, morbidity, and mortality. Therefore, effective treatment and long-term management of diabetes requires a patient-centered collaborative model of care with an understanding of the factors associated with nonadherence. This may help develop patient-, provider-, and system-focused strategies to help increase the rates of medication adherence, reduce complications associated with uncontrolled diabetes, and lower the overall cost of management.