Healthcare Cost Trends in New Users of SGLT ‐2i, DPP ‐4i and GLP ‐1 RA for Type 2 Diabetes: An Observational Longitudinal Study
Authors' conclusion
Patients with type 2 diabetes initiating on a GLP-1 RA show significantly higher pharmacy cost patterns as compared to the DPP-4i and SGLT-2i groups; this higher pharmacy cost is not offset by reduced medical cost during the same period.
Study context
- Population
- Treatment-naïve patients with T2D initiating therapy in 2020 or 2021, claims data of a national pharmacy benefit manager
- Exposure
- GLP-1 RA vs SGLT2i vs DPP-4i initiation
- Outcome
- Year-over-year changes in per patient per month (PPPM) medical, pharmacy and total cost of care expenditures
- Follow-up
- 2 years
Methodological detailsdifference-in-difference, propensity score weighting, claims data
- Difference-in-difference
- Propensity score weighting
- Claims data
Main finding
As reported in the abstract
Year-over-year changes in PPPM costs · years 1 and 2
- Changes in medical costs were not statistically different across drug groups in years 1 and 2
- Increase in pharmacy costs in year 1 significantly higher for GLP-1 RA than the other two drugs
- Total cost of care trajectories, driven primarily by pharmacy costs, showed similar between-drug differences
- Propensity score weighting
Observational data: associations, not effects.
Original publication
Healthcare Cost Trends in New Users of SGLT ‐2i, DPP ‐4i and GLP ‐1 RA for Type 2 Diabetes: An Observational Longitudinal Study. Diabetes Obes Metab. Published 14 June 2026. doi:10.
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