Health insurers’ expenditure on diabetes medication increased from 233 million euros to almost 411 million euros between 2020 and 2024, an increase of 76 percent. The costs for medication for type 2 diabetes in particular increased: from 86 million euros in 2020 to almost 287 million euros last year. That is more than a threefold increase.
Link with obesity
More than 1.2 million Dutch people have diabetes. About 90 percent of them suffer from type 2. This type usually develops later in life and is related to hereditary predisposition and an unhealthy lifestyle. Many people with type 2 diabetes are also overweight or obese.
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There are large regional differences in the number of people with diabetes. Drenthe has relatively the most patients (7.8%), followed by Limburg (7.6%) and Groningen (7.2%). The municipality of Stadskanaal takes the cake: 10.4% of the residents there have diabetes. In Oegstgeest that share is the lowest at 3.4%.
New users
A significant part of the increase in drug expenditure is caused by the increasing use of semaglutide drugs, of which Ozempic is the best known. About 90 million euros of the total cost increase is explained by more than 90,000 new users.
“Almost half of the increase is due to the so-called Ozempic effect,” says Bas Knopperts, health insurance expert at Independer. “It is popularly known as a weight-loss aid, but it is primarily intended for people with type 2 diabetes.”
Remarkably, the costs for insulin, which is mainly used by people with type 1 diabetes, fell by an average of more than 15% during the same period.
‘Premiums will rise’
Because diabetes medication is reimbursed by basic insurance, health insurers immediately feel the rising costs. This could have consequences for all insured persons. “If insurers start spending more on diabetes medication, premiums will ultimately rise for everyone,” Knopperts warns.
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Although Ozempic and drugs such as Mounjaro appear to work well in the treatment of obesity, the drugs are not yet reimbursed for this. In the coming months, the Healthcare Institute will examine whether Wegovy (a variant of Ozempic) and Mounjaro can be included in the basic package for people with severe obesity. If that is the case, the costs for health insurers are expected to rise much further.
Many Dutch people who want to lose weight do not wait for this decision on reimbursement and pay for the products themselves. This costs them an average of a few hundred euros per month.