Presentation (CTI)

OBJECTIVES:
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly used in the management of type 2 diabetes mellitus (T2DM) due to their glycemic and cardiometabolic benefits. Despite their clinical importance, concerns persist regarding affordability, particularly patient out-of-pocket (OOP) spending. Nationally representative evidence on real-world trends in GLP-1 RA use and associated OOP costs in the United States remains limited.
To examine trends in utilization and out-of-pocket prescription drug spending for GLP-1 receptor agonists among U.S. adults with type 2 diabetes from 2018 to 2023.
METHODS:
This retrospective cross-sectional study used Medical Expenditure Panel Survey (MEPS) data from 2018-2023. Adults aged 18 years and above with type 2 diabetes were identified from medical conditions files, and GLP-1 RA use was determined from prescribed medicines files. Outcomes included annual prevalence of GLP-1 RA use and mean annual OOP prescription drug expenditures. Survey-weighted descriptive analyses assessed temporal trends. Multivariable generalized linear models with a log link and gamma distribution evaluated changes in OOP spending over time, adjusting for sociodemographic characteristics, insurance status, income level, comorbidities, and self-reported health status. All analyses accounted for the complex MEPS survey design and were conducted using Stata.
RESULTS:
Preliminary analyses indicate that GLP-1 RA utilization among U.S. adults with type 2 diabetes increased steadily between 2018 and 2023. Early findings also suggest a concurrent increase in mean annual OOP prescription drug spending. Adjusted analyses are ongoing to further evaluate trends across survey years and patient subgroups.
CONCLUSIONS:
Between 2018 - 2023, utilization of GLP-1 receptor agonists among U.S. adults with type 2 diabetes increased substantially and was accompanied by rising out-of-pocket spending. These findings highlight growing affordability concerns and underscore the need for policy and payer strategies to improve equitable access to GLP-1 therapies.