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Comparison of Diabetes Medicines Used by Adults with Commercial Insurance and Medicare Advantage from 2016 to 2019

Updated

Abstract

Adjusted rates of initiation of GLP-1RA treatment increased from 1.50% to 11.44% among Medicare Advantage beneficiaries between 2016 and 2019.

  • From 2016 to 2019, initiation rates for GLP-1RA, SGLT2i, and DPP-4i treatment increased among both Medicare Advantage and commercial insurance beneficiaries.
  • Initiation rates for GLP-1RA among commercial beneficiaries rose from 2.14% to 20.02%, while rates for Medicare Advantage beneficiaries increased from 1.50% to 11.44%.
  • SGLT2i treatment initiation rates grew from 2.74% to 18.15% for commercial beneficiaries and from 1.57% to 8.51% for Medicare Advantage beneficiaries.
  • For DPP-4i, initiation rates increased from 3.30% to 11.71% among commercial beneficiaries and from 2.44% to 7.68% among Medicare Advantage beneficiaries.
  • Overall, initiation rates for all three drug classes were consistently lower among Medicare Advantage beneficiaries compared to their commercially insured counterparts.
  • The odds of starting GLP-1RA and SGLT2i treatment were found to increase with higher income levels.

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Funding

Competing interests

Conflict of Interest Disclosures: Dr McCoy reported receiving a Quality Measure Innovation Grant from the AARP outside the submitted work. Dr Karaca-Mandic reported receiving grants from the American Cancer Society, receiving personal fees from Sempre Health and Precision Health Economics, serving as chief executive officer and co-founder of XanthosHealth LLC, and serving as advisor to Koya Medical, Inc, outside the submitted work. Dr Ross reported receiving grants from the US Food and Drug Administration (FDA), Johnson & Johnson, Medical Devices Innovation Consortium, the Agency for Healthcare Research and Quality (AHRQ), the National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), the Laura and John Arnold Foundation, the Centers for Medicare & Medicaid Services, and Medtronic, Inc, outside the submitted work. Dr Shah reported receiving research support through Mayo Clinic from the FDA to establish the Yale-Mayo Clinic Center for Excellence in Regulatory Science and Innovation program, the Centers of Medicare & Medicaid Innovation under the Transforming Clinical Practice Initiative, the AHRQ, the NHLBI, NIH, the National Science Foundation, and the Patient Centered Outcomes Research Institute. No other disclosures were reported.
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