Medicare Advantage analysis compared healthcare resource use and costs between GLP-1 and SGLT2 inhibitor users with type 2 diabetes.
Medicare AdvantageLarge claims database comparing healthcare costs of GLP-1 RAs vs SGLT2i in real-world diabetes care
What the researchers found
Retrospective comparison of healthcare costs and resource utilization between GLP-1 RA and SGLT2i initiators in Medicare Advantage patients with type 2 diabetes.
Why it matters
With both drug classes recommended as first-line, understanding their cost implications helps inform formulary decisions and value-based care.
The numbers in context
N=22,167 per group; mean age 68.2; 52.2% female; 73.4% White; no significant differences in inpatient stays, ED visits, or all-cause costs at 12 months.
How the study worked
Retrospective cohort study using Humana Medicare Advantage Prescription Drug plan claims data (2018-2022).
Who was studied
Medicare Advantage beneficiaries with type 2 diabetes newly starting GLP-1 RA or SGLT2i (mean age 68.2)
What this study cannot tell us
Claims data cannot capture clinical nuance. Medicare Advantage population may not generalize to commercial or Medicaid populations.
How to read the evidence
Retrospective claims analysis — good for cost comparisons but limited by coding accuracy and unmeasured confounders.
When this study was published
Published in 2025, providing timely health economics data as GLP-1 drug costs dominate pharmacy spending discussions.
The bigger picture
As healthcare systems weigh expensive GLP-1 drugs against SGLT2 inhibitors, total cost-of-care analyses inform smarter formulary and coverage decisions.
Questions still open
- Do initial cost differences even out over time due to reduced complications?
- How do combination therapy costs compare to monotherapy with either class?
Common questions
Are GLP-1 drugs more expensive than SGLT2 inhibitors overall?
Which diabetes drug class is a better value?
Read the original research
Health care resource utilization and costs in Medicare Advantage beneficiaries using glucagon-like peptide-1 receptor agonists vs sodium-glucose cotransporter-2 inhibitors.
Journal of managed care & specialty pharmacy, 31(7), 627-640
Citation
Poonawalla, Insiya B; Abdal, Petir; Hayes, Mary; John, Isha; Diaz, Monica; Dixon, Suzanne; Bowe, Andy. (2025). Health care resource utilization and costs in Medicare Advantage beneficiaries using glucagon-like peptide-1 receptor agonists vs sodium-glucose cotransporter-2 inhibitors.. Journal of managed care & specialty pharmacy, 31(7), 627-640. https://doi.org/10.18553/jmcp.2025.31.7.627