Medical Expenditure Panel Survey Agency for Healthcare 

Research and Quality

STATISTICAL BRIEF #118 

March 2006 

A Comparison of Antidiabetic Agent 

Prescribed Medications: Oral Medicines 

and Insulin, 1997 and 2003 

Highlights 

 Total expenditures on prescribed antidiabetic agents 

more than tripled from 1997 

to 2003, increasing from 

$3.0 billion in 1997 to $11.2 

billion in 2003.

 From 1997 to 2003, total 

expenses on prescribed 

antidiabetic oral medicines 

quadrupled, going from $2.0 

billion to $8.0 billion; and 

total expenses for prescribed 

insulin (which is injected) 

tripled, going from $1.0 

billion to $3.2 billion. 

 From 1997 to 2003, antidiabetic agent prescribed 

medicine total purchases 

increased from 85.5 million 

to 146.4 million purchases. 

 When comparing 1997 and 

2003, total purchases of 

prescribed oral antidiabetic 

agents more than doubled, 

going from 50.3 million to 

108.6 million purchases, 

whereas prescribed insulin 

(injectable antidiabetic 

agents) did not significantly 

increase, going from 35.3 

million to 37.8 million 

purchases. 

 The number of people using

prescribed insulin did not 

significantly increase from 

1997 to 2003; however, the 

number of people using 

prescribed antidiabetic oral 

medications increased 

significantly, from 6.3 million 

to 10.8 million persons. 

Marie N. Stagnitti, MPA 

Introduction 

This Statistical Brief compares 1997 and 2003 data for the U.S. 

civilian noninstitutionalized (community) population from the 

Household Component of the Medical Expenditure Panel Survey 

(MEPS-HC) on the total expenditures, total number of purchases, 

and number of people with purchases of prescribed antidiabetic 

medicines. In addition to the larger therapeutic subclass of 

prescribed antidiabetic agents, similar trend data are provided for 

two smaller groupings of prescribed medications that comprise the 

subclass of antidiabetic agents: insulin (which is an injectable) and 

oral antidiabetic medicines (which include sulfonylureas, 

nonsulfonylureas, alpha glucosidase inhibitors, thiazolidinediones, 

meglitinides, and antidiabetic combinations). All differences

discussed in the text are statistically significant at the 0.05 level. 

Expenditures are in nominal dollars. 

Findings

From 1997 to 2003, total expenditures on antidiabetic prescribed

medicine agents had over a threefold increase, going from $3.0 

billion to $11.2 billion. Among the two subcategories within the larger 

antidiabetic category, total expenses for insulin tripled (from $1.0 

billion to $3.2 billion), and oral medicines total expenses quadrupled 

(from $2.0 billion to $8.0 billion). (figure 1) 

In 2003, the subcategory of oral medications represented 71.1 

percent of total dollars spent on the prescribed antidiabetic 

medications category, and insulin made up the remaining 28.9 

percent. There was no significant difference in the proportion that 

insulin and oral medications represented of antidiabetic prescribed 

medicine expenditures when comparing the years 2003 and 1997. 

(figure 2) 

When comparing 1997 and 2003, prescribed antidiabetic agent total

purchases increased from 85.5 million purchases to 146.4 million 

purchases. The subcategory of oral medicines within the larger 

category of prescribed antidiabetic agents more than doubled, 

increasing from 50.3 million purchases to 108.6 million purchases. 
The total number of purchases for the subcategory of insulin did not significantly increase when 

comparing the two years, increasing from 35.3 million purchases to 37.8 million purchases. (figure 3) 

The proportion of prescribed antidiabetic agents that oral medications represented of total purchases 

increased from 58.8 percent in 1997 to 74.2 percent in 2003, whereas the proportion that insulin 

represented of total purchases for prescribed antidiabetic agents decreased from 41.2 percent to 25.8 

percent (figure 4). 

The number of people having one or more prescribed antidiabetic agent purchases increased from 9.2 

million persons in 1997 to 13.0 million persons in 2003. The number of people having an insulin expense 

did not significantly increase when comparing 1997 and 2003 (4.0 million persons versus 4.2 million, 

respectively). However, the number of persons having an oral prescribed medicine antidiabetic agent 

expense increased from 6.3 million persons in 1997 to 10.8 million persons in 2003. (figure 5) 

In 1997, the mean expense for all prescribed antidiabetic agents was $34.81, and the mean expense for 

all prescribed antidiabetic agents in 2003 was more than double that, at $76.55. Moreover, when 

comparing 1997 and 2003, the mean expense for insulin tripled, going from $27.47 to $85.64, and the 

average expense for oral antidiabetic prescribed medicines nearly doubled, going from $39.97 to $73.39. 

(figure 6) 

Data Source 

Estimates were derived from the 1997 and 2003 MEPS full-year prescribed medicines files. The 

antidiabetic agent therapeutic subclass, and the sub-subclasses of insulin and oral medications were 

identified by linking the MEPS prescribed medicines files to the Multum Lexicon database. For additional 

information on the Multum Lexicon database, please refer to the following Web site: 

http://www.multum.com/Lexicon.htm. 

Definitions 

Antidiabetic agents: Insulin and oral medications 

Therapeutic class, subclass, and sub-subclass were assigned to MEPS prescribed medicines using 

Multum Lexicon variables from Cerner Multum, Inc. MEPS prescribed medicines files were linked to the 

Multum Lexicon database to obtain the therapeutic class related variables. All antidiabetic agent events in 

MEPS were defined as those events assigned the subclass antidiabetic agent by the Multum Lexicon 

database (TC1S1=99). All insulin events were assigned the sub-subclass of insulin (TC1S1_1=215) 

within the subclass of antidiabetic agents. The oral medications grouping within the subclass of 

antidiabetic agents includes sulfonylureas (TC1S1_1=213), nonsulfonylureas (TC1S1_1=214), alpha 

glucosidase inhibitors (TC1S1_1=216), thiazolidinediones (TC1S1_1=271), meglitinides (TC1S1_1=282), 

and antidiabetic combinations (TC1S1_1=314). For additional information on these and other Multum 

Lexicon variables, as well as the Multum Lexicon database itself, please refer to the following Web site: 

http://www.multum.com/Lexicon.htm. 

Use 

Use was defined as one or more purchases of a prescribed medicine in a therapeutic subclass or subsubclass of interest. Individuals were classified as using a prescribed medicine of interest if they had one 

or more purchases of a drug in a subclass or sub-subclass of interest during the year. 

Although in some states a prescription is not needed to purchase insulin, it is important to note that in this 

brief only household mentions of prescribed insulin purchases are included. 

Expenditures 

Expenditures are in nominal dollars. 

About MEPS-HC 

MEPS-HC is a nationally representative longitudinal survey that collects detailed information on health 

care utilization and expenditures, health insurance, and health status, as well as a wide variety of social, 

demographic, and economic characteristics for the civilian noninstitutionalized population. It is 
cosponsored by the Agency for Healthcare Research and Quality and the National Center for Health 

Statistics. 

For more information about MEPS, call the MEPS information coordinator at AHRQ (301-427-1656) or 

visit the MEPS Web site at http://www.meps.ahrq.gov/. 

References 

For a detailed description of the MEPS survey design, sample design, and methods used to minimize 

sources of nonsampling error, see the following publications: 

Cohen, J. Design and Methods of the Medical Expenditure Panel Survey Household Component. MEPS 

Methodology Report No. 1. AHCPR Pub. No. 97-0026. Rockville, Md.: Agency for Health Care Policy and 

Research, 1997. 

Cohen, S. Sample Design of the 1996 Medical Expenditure Panel Survey Household Component. MEPS 

Methodology Report No. 2. AHCPR Pub. No. 97-0027. Rockville, Md.: Agency for Health Care Policy and 

Research, 1997. 

Cohen, S. Design Strategies and Innovations in the Medical Expenditure Panel Survey. Medical Care,

July 2003: 41(7) Supplement: III-5–III-12. 

Suggested Citation 

Stagnitti, M. N. A Comparison of Antidiabetic Agent Prescribed Medications: Oral Medicines and Insulin, 

1997 and 2003. Statistical Brief #118. March 2006. Agency for Healthcare Research and Quality, 

Rockville, Md. http://www.meps.ahrq.gov/papers/st118/stat118 

∗ ∗ ∗

AHRQ welcomes questions and comments from readers of this publication who are interested in 

obtaining more information about access, cost, use, financing, and quality of health care in the United 

States. We also invite you to tell us how you are using this Statistical Brief and other MEPS data and 

tools and to share suggestions on how MEPS products might be enhanced to further meet your needs. 

Please e-mail us at mepspd@ahrq.gov or send a letter to the address below: 

Steven B. Cohen, PhD, Director 

Center for Financing, Access, and Cost Trends 

Agency for Healthcare Research and Quality 

540 Gaither Road 

Rockville, MD 20850 
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey,

1997 and 2003.

Figure 1. Total expenditures for prescribed antidiabetic

agents: Oral medicines and insulin, 1997 and 2003

3.0

1.0

2.0

11.2

3.2

8.0

0

2

4

6

8

10

12

All prescribed antidiabetic agents Insulin Oral medicines

1997 2003

N

o

minal d

ollars in billions

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey,

1997 and 2003.

Figure 2. Percentage distribution of total 

expenses for prescribed antidiabetic agents:

Oral medicines and insulin, 1997 and 2003

32.5 28.9

67.5 71.1

0

50

100

1997 2003

Insulin Oral medicines

Percent
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey,

1997 and 2003.

Figure 3. Total purchases of prescribed antidiabetic

agents: Oral medicines and insulin, 1997 and 2003

85.5

35.3

50.3

146.4

37.8

108.6

0

50

100

150

All prescribed antidiabetic agents Insulin Oral medicines

1997 2003

In millions

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey,

1997 and 2003.

Figure 4. Percentage distribution of total purchases 

of prescribed antidiabetic agents: Oral medicines 

and insulin, 1997 and 2003

41.2

25.8

58.8

74.2

0

50

100

1997 2003

Insulin Oral medicines

Percent
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey,

1997 and 2003.

Figure 5. Number of persons with purchase of

prescribed antidiabetic agent: Oral medicines

and insulin, 1997 and 2003

9.2

4.0

6.3

13.0

4.2

10.8

0

2

4

6

8

10

12

14

All prescribed antidiabetic agents Insulin Oral medicines

1997 2003

Note: The two subcategories of insulin and oral medicines do not add up to the total of the larger category all prescribed antidiabetic

agents because a person can be represented in both of the subcategories but only once in the larger grouping. In millions

 

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey,

1997 and 2003.

Figure 6. Mean expenditure for prescribed 

antidiabetic agents: Oral medicines 

and insulin, 1997 and 2003

34.81

27.47

39.97

76.55

85.64

73.39

0

20

40

60

80

100

All prescribed antidiabetic agents Insulin Oral medicines

1997 2003

N

o

minal d

ollars