OBJECTIVES: This study seeks to evaluate the effectiveness of GLP-1 Receptor Agonists (GLP-1 RA) and SGLT-2 Inhibitors (SGLT-2i) for lowering HbA1c and reducing health care costs and utilization in members with Type 2 Diabetes.

METHODS: Researchers assessed claims for Blue Cross and Blue Shield of Louisiana members with Type 2 Diabetes from June 2018 to March 2021 for antidiabetic medications. Members adherent to antidiabetic medications were included in the analysis. Two treatment cohorts were evaluated – one for GLP-1 RA use and the other for SGLT-2i use. The control cohort was members receiving standard-of-care medications. Exclusions were Type 1 Diabetes, gap of treatment greater than 90 days, and/or members receiving both GLP-1-RA and SGLT-2i medications. Each treatment cohort was matched to the control on demographics, risk scores, comorbidities, treatment length and insulin use. Researchers conducted difference-in-difference analyses using regression models with gamma and Poisson distribution on cost and utilization, respectively.

RESULTS: The results indicate that for members with Type 2 Diabetes, GLP-1 RA and SGLT-2i use effectively reduced HbA1c by 0.6% and 0.3%, respectively.

GLP-1 RA users had a slower growth in medical costs, acute admissions, and emergency room visits, while SGLT-2i users had fewer emergency room visits and significantly fewer avoidable hospital admissions (p-value < 0.05), compared to those who received the standard of care.

For members with Type 2 Diabetes and a chronic coronary condition, GLP-1 RA and SGLT-2i users had lower medical costs and fewer specialty visits compared to those who received the standard of care.

CONCLUSIONS: Researchers observed health care utilization improvements and lower HbA1c for GLP-1 RA and SGLT-2i users. Longer follow-up is needed to further confirm reduced health care costs associated with GLP-1 RA and SGLT-2i use.