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  • Robert Alongi

Medicare Part-D Costs With New Diabetes Medication Recommendations May Lead to Nonadherence

Dear Pharmacists,

On September 14, JAMA Internal Medicine posted a research letter concerning common diabetes medication and their out-of-pocket costs to patients. After using Metformin as a first-line agent, new diabetes guidelines recommend sodium-glucose cotransporter-2 inhibitors (SGLT2is), glucagon-like peptide-1 receptor agonists (GLP-1RAs), and dipeptidyl peptidase-4 inhibitors (DPP-4is) as the preferred second-line agents compared to typical sulfonylureas and thiazolidinediones (TZDs). However, the costs of the SGLT2is, GLP-1s, and DDP-4is are vastly more expensive in comparison to the sulfonylureas and TZDs. For Medicare Part-D plans nationwide, the average monthly price of the SGLT2is, GLP-1s, and DDP-4is ranges from $434–$935 compared to Metformin, sulfonylureas and TZDs monthly costs ranging from $3-$11. This portrays annual costs becoming $5202-$11,225 for new recommended medication therapies compared with $31 to $136 for the traditional drugs used.

In the discussion, it is noted that higher drug costs may lead to adherence issues with patients. Having a close relationship with patients and their medications, it is important for pharmacists to be able to identify these patients with diabetes who may have problems affording their medications (missing refills, saying they don’t want to fill their diabetes medication at this time, etc.) and find alternatives to reduce their prescription costs.

For more information on this research letter, please visit the following website (subscription may be required) or email us directly:

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