The Study
Health care resource utilization and costs in Medicare Advantage beneficiaries using glucagon-like peptide-1 receptor agonists vs sodium-glucose cotransporter-2 inhibitors.
This study looked at what happened to people who started taking two different diabetes medicines, but it didn’t randomly assign them—it just watched what happened in real life. So we can say the two groups had different costs, but we can’t say one medicine caused those differences because other things (like how healthy people were or what doctors chose) might have influenced it.
Analysis score
Maximum 72 for a cohort study.
Where the score came from
This study looked at two types of diabetes pills: GLP-1 RAs (like Ozempic) and SGLT2is (like Farxiga). It compared how much they cost and how often people went to the hospital.
Where does this study sit?
Reviews of RCTs (Meta-analyses)
Max 100Randomized Trials
Max 90Reviews of Cohort Studies
Max 85Cohort Studies
Max 72Reviews of Case-Control Studies
Max 63Case-Control Studies
Max 58Cross-Sectional & Case Series
Max 50Expert Opinion
Max 567 / 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.
Key takeaways
Summary
Based on the study abstract and findings.
- 1Even though GLP-1 RAs cost more, they didn’t reduce hospital use — except in obese patients, where they may have lowered other medical expenses, possibly due to weight loss or improved health.
- 2People on GLP-1 RAs paid 6–9% more for their pills.
- 3Total costs were 4–6% higher overall.
- 4But they didn’t go to the hospital or ER more often.
- 5In obese patients, GLP-1 RAs led to 2.9% lower medical costs (like doctor visits).
Score breakdown, methodology, conflicts of interest, evidence analysis & raw study data
Publication
Journal
Journal of managed care & specialty pharmacy
Year
2025
Authors
Insiya B Poonawalla, Petir Abdal, M. Hayes, Isha John, Monica Diaz, Suzanne W. Dixon, Andy Bowe
Related Content
Claims (6)
In older adults with type 2 diabetes and heart disease, starting GLP-1 RA drugs leads to 8.9% higher drug costs than starting SGLT2i drugs, with no difference in hospital visits, emergency room use, or other medical expenses.
Among Medicare Advantage patients with type 2 diabetes, starting a GLP-1 RA medication or an SGLT2i medication results in the same rate of hospital visits and emergency department visits over 12 months.
Among Medicare Advantage patients with type 2 diabetes, those who start GLP-1 RA medications pay 6% to 9% more in pharmacy costs than those who start SGLT2i medications, regardless of whether they have heart disease or obesity, because the GLP-1 RA drugs are priced higher.
When older adults are prescribed GLP-1 agonists, the total cost of their prescription medications increases for Medicare.
Among Medicare Advantage patients with type 2 diabetes, starting GLP-1 RA medications results in 9.0% higher drug costs and 5.7% higher overall health care costs over one year compared to starting SGLT2i medications, with no difference in hospital or emergency room use.
In Medicare Advantage patients with type 2 diabetes and obesity, starting GLP-1 RA drugs results in 2.9% lower overall medical costs over 12 months than starting SGLT2i drugs, even though GLP-1 RA drugs cost 9.5% more in pharmacy expenses.
Not medical advice. For informational purposes only. Always consult a qualified healthcare professional before making health decisions.