80% With Diabetes Eligible for New Drugs, but Cost Is a Barrier

80% With Diabetes Eligible for New Drugs, but Cost Is a Barrier

March 6, 2023 — More than 80% of U.S. adults with type 2 diabetes meet the criteria to use new treatment drugs, such as semaglutide, which is marketed as Ozempic, according to a new study published in the Annals of Internal Medicine.

However, only about 1 in 10 of those who meet the criteria used the drugs in recent years, the study found. In addition, the high prices for some of the drugs means they may put them out of reach as the first drug treatment for these patients. Most people with type 2 diabetes are prescribed metformin initially, but generally have other medications added on, but some of the newer drugs are now recommended as first-line treatment for some. 

“It’s critical that we continue to study the best ways to manage type 2 diabetes (including medications and lifestyle changes), but it’s also important to examine how available these methods are to people,” says lead author Shichao Tang, PhD, a researcher with the Division of Diabetes Translation at the CDC’s National Center for Chronic Disease Prevention.

“This includes researching how many people are using certain tools or medications and how many people are eligible for them, which was the aim of this study,” Tang says. 

A 2022 report from the American Diabetes Association and European Association for the Study of Diabetes recommended the use of certain drugs, such as Ozempic, which is given as a weekly injection, with other similar drugs available as daily injections, and oral tablets, for patients with type 2 diabetes. 

This is because, as well as lowering blood sugar, these new drugs have been found to reduce the risks of complications of diabetes, such as heart disease and kidney disease, and they also result in weight loss, compared with older drugs. 

The researchers estimated that, for the 22.4 million U.S. adults with diagnosed type 2 diabetes, about 82.3% would meet the recommended criteria to use drugs from these two new classes. About 94.5% of Medicare recipients with type 2 would be recommended to use them as well.

However, only 3.7% of those who met the criteria used them during the study period and just 5.3% of those eligible for the oral tablets used them. 

About 9.1% used either of them before the most recent 2022 guidelines, which opened up the medications as first-line treatment for patients with type 2 diabetes.

Based on retail prices listed on a US-based website, a 30-day supply of an oral tablet drug can cost about $550-$600/month, while common injected drugs can run from a few hundred dollars for a daily injection or close to $1,000 for a version given weekly.

Prior studies suggest that the two drug types could be cost-effective as second-line treatments, the authors note. However, the current costs would need to drop by 70% for them to be cost-effective as first-line treatments. 

Additional studies are needed to understand if the new treatments are cost-effective for certain patient subgroups as first-line medications.

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