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The Study

Healthcare Cost Trends in New Users of SGLT-2i, DPP-4i and GLP-1 RA for Type 2 Diabetes: An Observational Longitudinal Study.

In simple terms

This study looked at how much money people spent on medicine and doctor visits after starting different diabetes pills. It found that people who started one kind of pill (GLP-1 RA) tended to spend more on their prescriptions, but it doesn’t prove that the pill itself made them spend more — maybe those people were sicker or had better insurance.

58%

Analysis score

58/ 72

Maximum 72 for a cohort study.

Where the score came from

Reporting40
Methodology31
Publication100
Statistical77
Study type (basis of the score)
Cohort Study
Level 2b - Individual cohort study
What’s the bottom line?

This study looked at how much money people with type 2 diabetes spend on medicine and doctor visits after starting different types of diabetes pills.

Where does this study sit?

Reviews of RCTs (Meta-analyses)

Max 100

Randomized Trials

Max 90

Reviews of Cohort Studies

Max 85

Cohort Studies

Max 72

Reviews of Case-Control Studies

Max 63

Case-Control Studies

Max 58

Cross-Sectional & Case Series

Max 50

Expert Opinion

Max 5
StrongerWeaker
Cohort Studies
Level 2b
58

58 / 100

Quality score

Groups of people are followed over time to see who develops an outcome. Strong for identifying risk factors and associations, but cannot prove causation as firmly as RCTs.

Cannot establish causation

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Key takeaways

Summary

Based on the study abstract and findings.

  1. 1Yes—higher drug prices directly increase overall healthcare spending without saving money elsewhere, which matters for insurance plans and patients.
  2. 2People who started GLP-1 drugs spent much more on pharmacy costs in the first year—no less on hospital visits or doctor appointments compared to those who started other pills.

Score breakdown, methodology, conflicts of interest, evidence analysis & raw study data

Publication

Journal

Diabetes, obesity & metabolism

Year

2026

Authors

Casey P Durand, M. Eatherly, Aaron Yao, T. Dollear, A. Inneh, Urvashi Patel

1 citations
Analysis v6

Related Content

Claims (6)

Assertion

When older adults are prescribed GLP-1 agonists, the total cost of their prescription medications increases for Medicare.

Correlational
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Assertion

Among adults with type 2 diabetes, starting GLP-1 receptor agonists results in similar total medical costs over two years as starting SGLT-2 inhibitors or DPP-4 inhibitors, even though GLP-1 agonists are more expensive as prescription drugs.

Correlational
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Assertion

Adults with type 2 diabetes who start GLP-1 receptor agonists pay more for their medications in the first year than those who start SGLT-2 inhibitors or DPP-4 inhibitors, and this higher cost is not offset by lower spending on other medical services over two years.

Correlational
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Assertion

For adults with type 2 diabetes, the increased cost of GLP-1 receptor agonist medications starts within the first year of use and remains similar in the second year, showing that the higher expense is ongoing and not temporary.

Descriptive
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Assertion

In the first year after starting treatment, adults with type 2 diabetes who begin GLP-1 receptor agonists incur higher total healthcare costs than those who start SGLT-2 inhibitors or DPP-4 inhibitors, because drug costs are higher and there is no corresponding decrease in other medical expenses.

Quantitative
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Assertion

The higher cost of GLP-1 receptor agonists compared to other type 2 diabetes drugs comes mostly from pharmacy pricing and insurance formulary rules, not from medical care expenses.

Descriptive
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Not medical advice. For informational purposes only. Always consult a qualified healthcare professional before making health decisions.