Adherence to GLP ‐1 receptor agonists and SGLT2 inhibitors by out‐of‐pocket spending among Medicare beneficiaries with diabetes
Authors' conclusion
OOP costs for GLP-1RAs and SGLT2i are substantial, potentially posing a particular burden for low-income Medicare beneficiaries. Policy changes may reduce this burden, although adherence improvements appear limited to beneficiaries using SGLT2i.
Study context
- Population
- Medicare beneficiaries with diabetes using GLP-1RAs or SGLT2i in year one; low-income = income below 200% of the Federal Poverty Level
- Participants
- 97 vs 73
- Exposure
- Baseline cumulative out-of-pocket (OOP) drug expenses and year-two adherence
- GLP-1RAn = 97
- SGLT2in = 73
- Outcome
- Association between baseline cumulative OOP drug expenses and adherence (proportion of days covered, PDC)
- Follow-up
- Year two
Methodological detailssurvey-weighted generalized Poisson regression, Medicare Current Beneficiary Survey 2016-2021
- Survey-weighted generalized Poisson regression
- Medicare Current Beneficiary Survey 2016-2021
Main finding
As reported in the abstract
- SGLT2i: higher OOP costs (mean $204; $0-$2649) associated with lower adherence, adjusted adherence ratio per $100 increase
- 0.959 (95% CI: 0.932-0.987)
Observational data: associations, not effects.
Further findings
Dual Medicare-Medicaid coverage and adherence
- Dual coverage associated with increased adherence, adjusted adherence ratio
- 1.580 (95% CI: 1.061-2.352)
High-income GLP-1RA users
- Higher OOP expenditures associated with increased adherence in the highest income range
Original publication
Adherence to GLP ‐1 receptor agonists and SGLT2 inhibitors by out‐of‐pocket spending among Medicare beneficiaries with diabetes. Diabetes Obes Metab. Published 16 July 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →