OBJECTIVES: Among all diabetes medications, incretin-based and peptides therapies are considered as new effective medications for treating type 2 diabetes. We aimed to examine trends in utilization, reimbursement, and price of incretin-based and peptides therapies (IBPTs) for type 2 diabetes among the U.S. Medicaid population from 2005 through 2016. METHODS: Primary data source is from the national Medicaid pharmacy file collected by the Centers for Medicare & Medicaid Services (CMS). A descriptive, retrospective drug utilization analysis was conducted to calculate the quarterly number of prescription drug utilization and their reimbursement payment for each individual IBPTs brand and generic name from 2005 to 2016. Study drugs included Dipeptidyl Peptidase-4 Inhibitors, amylin analogs, and glucagon-like peptide-1 agonists, such as exenatide, pramlintide, sitagliptin, saxagliptin, liraglutide, linagliptin, alogliptin, and lixisenatide. Per-prescription reimbursement amount as a proxy of drug price was estimated using total reimbursement amount divided by total number of prescriptions. RESULTS: Utilization and expenditure of IBPTs gradually increased in the period from 2005 to 2016. Sitagliptine was the most prescribed IBPTs among Medicaid population. In 2016, total number of Sitagliptine prescriptions reach 270,000 and total spending was US$110 million. Pramlintide was the most expensive IBPTs in the market with an average price of US$153 per-prescription in 2005, which increased to US$1,110 per-prescription in 2016. Market share of both Linagliptin and Liraglutide increased rapidly in 5 years science they entered the market comparing to other IBPTs. CONCLUSIONS: Analysis of Medicaid database showed increasing trends in utilization, reimbursement, and price for IBPTs during the 12-year period. Future study comparing trends of IBPTs to trends of other antidiabetic medications is warranted to examine their market share competition and compare their clinical implication.