Association of Prescription Co-payment With Adherence to Glucagon-Like Peptide-1 Receptor Agonist and Sodium-Glucose Cotransporter-2 Inhibitor Therapies in Patients With Heart Failure and Diabetes
Authors' conclusion
In this cohort study of individuals with T2D and/or HF, 1-year adherence to GLP1-RA or SGLT2i therapies was highest among individuals with a low co-payment. Improving adherence to guideline-based therapies may require interventions that reduce out-of-pocket prescription costs.
Study context
- Population
- Adults ≥18 years with T2D and/or heart failure (HF) with a prescription claim for a GLP-1 RA or SGLT2i, January 1, 2014, to September 30, 2020; mean (SD) age 61.8 (11.4) years, 54.1% male
- Participants
- 94,610 adults
- Exposure
- Medium or high vs low prescription co-payment
- Outcome
- Medication adherence: proportion of days covered (PDC) ≥80%
- Follow-up
- 1 year
Methodological detailsdeidentified claims data (Optum Clinformatics Data Mart), commercial and Medicare enrollees
- Deidentified claims data (Optum Clinformatics Data Mart)
- Commercial and Medicare enrollees
Main finding
As reported in the abstract
PDC ≥80% (adherence), by drug class
Each group vs lowAdjusted odds ratio (95% CI)
MediumGLP-1 RA
0.62(0.58–0.67)
HighGLP-1 RA
0.47(0.44–0.51)
MediumSGLT2i
0.67(0.63–0.72)
HighSGLT2i
0.68(0.63–0.72)
- GLP-1 RA claimants with proportion of days covered (PDC) ≥80% (of 39 149)
- 25 557 (65.3%)
- SGLT2i claimants with PDC ≥80% (of 51 072)
- 37 339 (73.1%)
Observational data: associations, not effects.
Original publication
Association of Prescription Co-payment With Adherence to Glucagon-Like Peptide-1 Receptor Agonist and Sodium-Glucose Cotransporter-2 Inhibitor Therapies in Patients With Heart Failure and Diabetes. JAMA Netw Open. Published 1 June 2023. doi:10.
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