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Study breakdown

GLP-1 Drugs vs. SGLT2 Inhibitors: Comparing Healthcare Costs in Medicare Patients

ObservationalModerate evidence
The takeaway

Medicare Advantage analysis compared healthcare resource use and costs between GLP-1 and SGLT2 inhibitor users with type 2 diabetes.

Medicare Advantage

Large 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?
This study compared not just drug costs but total healthcare spending including hospitalizations and other services between the two drug classes.
Which diabetes drug class is a better value?
Value depends on total cost-of-care, not just drug price — this study helps answer that for Medicare patients.

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