An analysis by Cedar Gate Technologies found that incretin mimetic prescription medications (also known as GLP-1 agonists) have overtaken insulin in total prescriptions and cost among commercially insured patients. These medications are commonly prescribed to treat type 2 diabetes.
Between July 2021 and June 2022, Cedar Gate’s proprietary national Healthcare Benchmark Database of over 12 million members examined the Top 10 therapeutic drug classes used to treat diabetes. The data unveils a significant 36.1% increase in GLP-1 agonist prescriptions and a 43.4% surge in costs for these medications. In contrast, insulin prescriptions experienced a 1.4% decrease during the same period, transitioning from the top-prescribed diabetes drug class in the preceding year to the second position on the list.
“Understanding what drives prescription costs in a population is critical to reducing costs and improving care quality for payers, providers, and self-funded employers,” said Raj Mahale, Chief Product and Business Development Officer at Cedar Gate. “We recently released a diabetes dashboard that makes it easy for Cedar Gate clients to view their own top 10 drug classes and identify key opportunities to lower costs and improve quality among their member populations.”
Incretin mimetics are a relatively new option for type 2 diabetes treatment. They mimic a hormone called glucagon-like peptide 1 (GLP-1), stimulating the body to produce more insulin. That lowers blood sugar levels. Other benefits include curbing appetite and lowering the risk of heart failure, stroke, and kidney failure in type 2 diabetes patients. Notably, the data suggests there may be a broader trend beyond diabetes treatment for GLP-1 agonists.
“Part of what is driving higher prescription rates and costs for incretin mimetic drugs could be the increase in off-label use of drugs like Ozempic and Trulicity,” said Ginger Pape, PharmD and Vice President of Product Management at Cedar Gate. These two medications occupied the #1 and #2 spots for the Top 10 drugs on the diabetes dashboard. They accounted for $544 million and $487 million, respectively, in total costs in a single year for pharmacy claims included in Cedar Gate’s analysis.
“Having access to high-quality analytics provides the ability to examine how drugs are being used, and identify short- and long-term impacts on cost and quality. These critical insights empower users to make better healthcare decisions,” Mahale said.
Cedar Gate helps payers, providers, and self-funded employers analyze data to help address the specific needs of diabetes patients, who have higher average healthcare costs than people without diabetes. With access to in-depth analytics tools and national and regional benchmarking capabilities, Cedar Gate also helps healthcare delivery organizations surface important trends in cost and utilization, such as the recent dramatic increase of GLP-1 prescriptions.
Catalyst for Payment Reform (CPR) also recently released a report on the effectiveness of diabetes point solutions to improve quality metrics and clinical outcomes. The report uses data from Cedar Gate’s Healthcare Benchmark Database to analyze whether point solutions for managing diabetes can provide a return on investment for self-funded employers and healthcare purchasers who have diabetic members in their population.
About Cedar Gate Technologies
Cedar Gate enables payers, providers, employers, and service administrators to excel at value-based care with a unified technology and services platform delivering analytics, population health, and payment technology on a single data management foundation. From primary care attribution to bundled payments to capitation, Cedar Gate is improving clinical, financial, and operational outcomes for every payment model in all lines of business.
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