The DOI matches its Crossref record; 28 of the 28 references it cites were found in a registry or an index.
Patterns and costs associated with glucagon-like peptide-1 receptor agonist use in US adults with type 2 diabetes
Open accessAbstract
BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) offer cardiorenal benefits in diabetes management. Since 2020, public awareness of GLP-1 RAs for diabetes, weight loss, and the prevention of cardiovascular disease has led to a surge in their utilization. However, the high cost of GLP-1 RAs and limitations in insurance coverage have been considered significant barriers to access. Current knowledge regarding how GLP-1 RA use affects total health care costs in diabetes care after 2020 in the United States remains limited. Consequently, further research is needed to examine the financial burden of GLP-1 RA use on patients and payers, as well as its overall impact on total health care costs at the national level. OBJECTIVE: To examine GLP-1 RA utilization and association with health care costs among US adults with type 2 diabetes. METHODS: Using data from the 2021-2022 Medical Expenditure Panel Survey, the study sample included individuals (aged ≥18 years) with a diagnosis of type 2 diabetes. Outcomes included GLP-1 RA use and all-cause and diabetes-related health care costs, including medical and prescription drug costs paid by patients and insurers. Generalized linear regression with a log link and gamma distribution was used to assess the effect of GLP-1 RA use on health care costs, adjusting for sociodemographic and health-related characteristics. RESULTS: Among 3,587 eligible adults with type 2 diabetes, 637 (18.8%) used GLP-1 RAs, representing an estimated 3.66 million US adults-a marked increase compared with pre-2020 estimates of less than 10%. Fewer older adults (aged ≥65 years) used GLP-1 RAs (35.1%) compared with adults aged 45-64 years (50.6%). The average annual per-person cost of GLP-1 RA was $6,947. Although insurance covered more than 95% of GLP-1 RA cost, these medications represented a substantial proportion of diabetes care costs: 63.3% of antidiabetic drug costs and 55.7% of total diabetes-related costs among GLP-1 RA users. After adjustment, GLP-1 RA use was associated with a 219% increase in diabetes-related costs and a 55.3% increase in total all-cause health care costs. CONCLUSIONS: GLP-1 RA utilization among US adults with type 2 diabetes has substantially increased, with use in 2021-2022 nearly double that of the period prior to 2020. The higher health care costs associated with taking GLP-1 RAs were largely attributable to high drug costs, of which over 95% were covered by insurance.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Annual out-of-pocket costs for GLP-1 RAs can exceed several thousand dollars and insurance coverage for obesity treatment varies widely across insurance plans and health systems.4,103”
From Weight maintenance after discontinuation of GLP-1 therapies (2026) · cites this paper as [103]
In the citing paper
“Annual out-of-pocket costs for GLP-1 RAs can exceed several thousand dollars and insurance coverage for obesity treatment varies widely across insurance plans and health systems.4,103”
From Weight maintenance after discontinuation of GLP-1 therapies (2026) · cites this paper as [103]
In the citing paper
“The market is characterized by high out-of-pocket costs, complex insurance utilization management, and recurrent supply shortages [27,40,41].”
From Adherence and Persistence with GLP-1-Based Therapies: International Real-World Evidence and the Role of Nutritional and Lifestyle Support—A Narrative Review (2026) · cites this paper as [41]
In the citing paper
“A factor unique to the U.S. market is forced discontinuation resulting from mid-year formulary changes or alterations in employer-sponsored coverage, which can interrupt therapy regardless of patient or physician preference [20,41,42].”
From Adherence and Persistence with GLP-1-Based Therapies: International Real-World Evidence and the Role of Nutritional and Lifestyle Support—A Narrative Review (2026) · cites this paper as [41]
Citations
Cites
The answer is 17 years, what is the question: understanding time lags in translational research
Morris, Z. S., Wooding, S., & Grant, J. (2011) · Journal of the Royal Society of Medicine · doi:10.1258/jrsm.2011.110180 · Cited by 3,340
Kristensen, S. L., Rørth, R., Jhund, P. S., Docherty, K. F., Sattar, N., Preiss, D., Køber, L., Petrie, M. C., & McMurray, J. J. V. (2019) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(19)30249-9 · Cited by 1,663
9. Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes—2020
American Diabetes Association (2020) · Diabetes Care · doi:10.2337/dc20-s009 · Cited by 914
Determinants of Adherence to Diabetes Medications: Findings From a Large Pharmacy Claims Database
Kirkman, M. S., Rowan-Martin, M. T., Levin, R., Fonseca, V. A., Schmittdiel, J. A., Herman, W. H., & Aubert, R. E. (2015) · Diabetes Care · doi:10.2337/dc14-2098 · Cited by 388
Efficacy and Safety of GLP-1 Medicines for Type 2 Diabetes and Obesity
Drucker, D. J. (2024) · Diabetes Care · doi:10.2337/dci24-0003 · Cited by 383
Adhikari, R., Jha, K., Dardari, Z., Heyward, J., Blumenthal, R. S., Eckel, R. H., Alexander, G. C., & Blaha, M. J. (2022) · Journal of the American Heart Association · doi:10.1161/jaha.121.023811 · Cited by 166
Sibony, R. W., Segev, O., Dor, S., & Raz, I. (2023) · International Journal of Molecular Sciences · doi:10.3390/ijms242417147 · Cited by 151
Karagiannis, T., Tsapas, A., Athanasiadou, E., Avgerinos, I., Liakos, A., Matthews, D. R., & Bekiari, E. (2021) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2021.108737 · Cited by 146
Arnold, S. V., Inzucchi, S. E., Tang, F., McGuire, D. K., Mehta, S. N., Maddox, T. M., Goyal, A., Sperling, L. S., Einhorn, D., Wong, N. D., et al. (2017) · European Journal of Preventive Cardiology · doi:10.1177/2047487317729252 · Cited by 144
Patel, M. R., Piette, J. D., Resnicow, K., Kowalski-Dobson, T., & Heisler, M. (2016) · Medical Care · doi:10.1097/mlr.0000000000000565 · Cited by 143
Flagged first, then by citations
Research works printed but not linked: 4
- Tran KL, 2017, Am Health Drug Benefits, 10, 178
- Elsayed NA, 2025, Diabetes Care, 48, S181
- Plodkowski R, 2017, Am Health Drug Benefits, 10, 187
- Elsayed NA, 2025, Diabetes Care, 48, S266
Cited by
Sorted by citations
Al-Dahi, W. A., Alenezi, A., Alessa, T., Alhamdan, R., Al-Humood, K., Alqallaf, A., AlOtaibi, T. M., AlRajab, H., Alshammari, A. M., Alyousef, A., et al. (2026) · Diabetes Therapy · doi:10.1007/s13300-025-01838-0 · Cited by 7
Weight maintenance after discontinuation of GLP-1 therapies
Moiz, A., Filion, K. B., Knäuper, B., Tsoukas, M. A., Brazeau, A.-S., Zolotarova, T., Lelièvre, A., & Eisenberg, M. J. (2026) · EClinicalMedicine · doi:10.1016/j.eclinm.2026.103992 · Cited by 7
Dziewierz, A., & Siudak, Z. (2026) · Nutrients · doi:10.3390/nu18111761 · Cited by 3
Prescribing Trajectories in Type 2 Diabetes in the United States, 2019–2024
Lux, T. S., Lee, D., Phillips, J. M., Facelli, J. C., Malone, D. C., Wahl, M., Reddy, D., Sakaguchi, F. H., Gouripeddi, R., Millar, A. S., et al. (2026) · Diabetes Obesity and Metabolism · doi:10.1111/dom.71013 · Cited by 1
Milani, I., Parrotta, M. E., Chinucci, M., Franzò, E., Gintoli, E., Franco, F., Sbraccia, P., Guglielmi, V., & Capoccia, D. (2026) · Frontiers in Endocrinology · doi:10.3389/fendo.2026.1819337
Metadata
- Authors
- Wu, J., Perez, A., & Sullivan, P. W.
- Affiliations
- Nova Southeastern University (US)
- Department of Sociobehavioral and Administrative Pharmacy, Barry and Judy Silverman College of Pharmacy, Nova Southeastern University, Fort Lauderdale, FL
- ORCID
- Sullivan, Patrick W.
- Venue
- Journal of Managed Care & Specialty Pharmacy
- Publisher
- Academy of Managed Care Pharmacy
- Published
- 2025-10
- Volume
- 31
- Issue
- 10
- Pages
- 1029-1038
- ISSN
- 2376-0540 (ISSN-L)
- 2376-1032
- PMC
- PMC12467763
- OpenAlex
- W4414563985
- Cited by
- 7
- References
- 28
- Citations by year
- 2026: 7
- FWCI
- 4.77
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Managed Care & Specialty Pharmacy (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- GLP-1 receptor agonists, type 2 diabetes, health care costs, medication utilization, prescription drug costs, insurance coverage, out-of-pocket costs, antidiabetic drugs, older adults, Medical Expenditure Panel Survey, weight loss, cardiovascular disease prevention, access barriers, United States adults
- MeSH terms
- Glucagon-Like Peptide-1 Receptor Agonists, Adult, Aged, Diabetes Mellitus, Type 2, Health Expenditures, Female, Humans, Hypoglycemic Agents, Male, Middle Aged, United States, Drug Costs, Health Care Costs, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
