OBJECTIVES:  A randomized controlled trial (DURATION-6) showed exenatide 2 mg once weekly (EQW) did not meet non-inferiority in A1C reduction in T2DM patients compared to liraglutide 1.8 mg once daily (LQD). The aim of this study was to compare real-world clinical and economic outcomes in patients receiving LQD vs EQW. METHODS:  This retrospective cohort study included adult commercial enrollees in a large US health plan with T2DM who initiated LQD or EQW between February 2012 and June 2014. Six-month baseline and follow-up data were evaluated. Change in A1C was calculated using A1C closest to index and closest to the end of 6-month follow-up. Diabetes-related costs were calculated for services with a diabetes diagnosis. Drug adherence was expressed as proportion of days covered (PDC). Differences between patients receiving LQD 1.2 mg or 1.8 mg vs EQW were described. Multivariate models of A1C and cost outcomes were utilized to address confounding. RESULTS:  The sample (LQD n=1250; EQW n=382) was 48% female and mean age was 53 years. Mean baseline A1C was balanced (LQD 1.2 mg: 8.5%; LQD 1.8 mg: 8.5%; EQW: 8.6%). After adjusting for confounders, estimated change in A1C was -0.74% for LQD 1.2 mg, -0.90% for LQD 1.8 mg, and -0.86% for EQW (P >0.05). Odds of achieving A1C <7.0% and ≤6.5% were similar between cohorts. Adjusted diabetes costs were $4934 for LQD 1.2 mg, $4950 for LQD 1.8 mg, and $5001 for EQW (P >0.05); however, pharmacy costs were significantly higher for LQD 1.8 mg and lower for LQD 1.2 mg compared to EQW. Six-month PDC was similar between cohorts (LQD 1.8 mg 0.68, EQW 0.65, and LQD 1.2 mg 0.63). CONCLUSIONS: