Trends in the utilization, expenditure and costs of noninsulin glucose-lowering drugs in the Medicaid population: Steady increases in glucagon-like peptide-1 receptor agonist and sodium-glucose transporter-2 inhibitor use, prices and expenditure.
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引用次数: 0
Abstract
Aims: This study aimed to analyse changes in the utilization, expenditure and average cost of noninsulin glucose-lowering drugs (GLDs) between 2008 and 2023.
Methods: This was a retrospective observational study of 2008-2023 data from the National Medicaid State Drug Utilization database. Drug utilization and annual Medicaid reimbursement amounts were calculated for all included medications. Average reimbursement/prescription costs were used to represent average prices. The Mann-Kendall test and Sen's slope estimator were used to evaluate trend significance and estimate median annual changes with 95% confidence intervals (CIs).
Results: Findings showed a significant increase in the total annual utilization (z = 4.997, Sen's slope: 2.53 million [95% CI: 2.26-2.95 million]), reimbursement amounts (z = 4.997, Sen's slope: $679 million [95% CI: $389 million-$1.04 billion]) and average prices (z = 3.467, Sen's slope: $13.24 [95% CI: $5.97-$21.53]) of the included drugs between 2008 and 2023 (all P < .001; Mann-Kendall test). Metformin dominated the market, accounting for 53% of the prescriptions, followed by sulfonylureas (20.5%). Medicaid spent $2.8 billion on metformin and $1.2 billion on sulfonylureas. This is relatively low compared to expenditure on other medications, such as glucagon-like peptide-1 (GLP-1) receptor agonists, which reached $35.5 billion. There was a notable shift toward the use of GLP-1 receptor agonists and sodium-glucose transporter-2 inhibitors, accompanied by a significant increase in their average cost and Medicaid spending on these drugs.
Conclusions: Metformin and sulfonylureas have remained the most prescribed and affordable noninsulin GLDs. However, there has been a shift toward greater utilization of GLP-1 receptor agonists and sodium-glucose transporter-2 inhibitors.
期刊介绍：
Published on behalf of the British Pharmacological Society, the British Journal of Clinical Pharmacology features papers and reports on all aspects of drug action in humans: review articles, mini review articles, original papers, commentaries, editorials and letters. The Journal enjoys a wide readership, bridging the gap between the medical profession, clinical research and the pharmaceutical industry. It also publishes research on new methods, new drugs and new approaches to treatment. The Journal is recognised as one of the leading publications in its field. It is online only, publishes open access research through its OnlineOpen programme and is published monthly.
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