Medicare Patients Stay on GLP-1 Drugs Longer Than SGLT-2 Inhibitors | Research

The takeaway

Medicare Advantage beneficiaries with type 2 diabetes show higher treatment persistence with GLP-1 receptor agonists compared to SGLT-2 inhibitors.

Higher GLP-1 RA persistence
Medicare patients stayed on GLP-1 drugs longer than SGLT-2 inhibitors across subgroups

What the researchers found

GLP-1 RA initiators showed higher treatment persistence compared to SGLT2i initiators among Medicare Advantage beneficiaries with T2DM, including subgroups with cardiovascular disease and obesity.

Why it matters

Medication persistence directly affects outcomes. Understanding which drugs patients stay on longer helps clinicians make better prescribing decisions and payers design coverage.

How the study worked

Retrospective claims analysis using Humana Healthcare Research data comparing treatment persistence and augmentation between new GLP-1 RA and SGLT2i users with type 2 diabetes.

What this study cannot tell us

Claims data cannot capture reasons for discontinuation. Medicare Advantage population may not represent all diabetes patients. Persistence does not equal adherence.

How to read the evidence

Retrospective claims analysis — provides real-world persistence data but cannot determine causation or reasons for differences.

When this study was published

Published in 2026; reflects current Medicare prescribing patterns.

The bigger picture

Higher GLP-1 persistence may reflect greater perceived benefit by patients, potentially contributing to the superior cardiovascular outcomes seen with this drug class.

Questions still open

What drives higher GLP-1 persistence — greater efficacy, weight loss, or other factors?
Does higher persistence translate to better long-term outcomes in this population?

Common questions

Why do people stay on GLP-1 drugs longer?

Possible reasons include visible weight loss benefits, greater perceived efficacy, and once-weekly dosing convenience. This study measured persistence but could not determine the specific reasons.

Does staying on medication longer mean better outcomes?

Generally yes — consistent medication use is strongly linked to better blood sugar control, fewer complications, and lower cardiovascular risk in diabetes patients.

Read the original research

Glucagon-like peptide-1 receptor agonist versus sodium-glucose cotransporter-2 inhibitor persistence in Medicare Advantage beneficiaries with type 2 diabetes, cardiovascular risk, and obesity.

Diabetes, obesity & metabolism, 28(1), 472-484

View on PubMed ↗Publisher’s paper ↗

Citation

Bowe, Andy; Hayes, Mary; John, Isha; Diaz, Monica; Dixon, Suzanne; Poonawalla, Insiya. (2026). Glucagon-like peptide-1 receptor agonist versus sodium-glucose cotransporter-2 inhibitor persistence in Medicare Advantage beneficiaries with type 2 diabetes, cardiovascular risk, and obesity.. Diabetes, obesity & metabolism, 28(1), 472-484. https://doi.org/10.1111/dom.70219