Jeter Anthony F, Melton Brittany L, Newell Bradley J
1 Baker's Pharmacy, Omaha, Nebraska.
2 The University of Kansas School of Pharmacy, Lawrence, Kansas.
Sr Care Pharm. 2025 Feb 1;40(2):97-104. doi: 10.4140/TCP.n.2025.97.
In 2022, federal law capped insulin product costs at $35 per month for Medicare prescription drug plan recipients. However, this law did not address the high costs of other antihyperglycemic medications, such as glucagon-like peptide-1 receptor agonists (GLP-1RAs), with an average copay of $120 per month. Under the law, fixed-ratio insulin/GLP-1RA combination products are classified as "insulin products," making these effective medications more accessible to patients who might otherwise be unable to afford them. Patients may not be aware of the potential financial benefits of combination products, highlighting the need to identify those using them to better educate both patients and providers. The primary objective was to identify predictors of use for the insulin/GLP-1RA combinations. The secondary objective was to determine if there was a difference in medication cost to patients between individual and combination product users and determine cost savings potential of switching. This was a retrospective, observational cohort analysis. Prescription fill data were examined for antihyperglycemic medications filled between January 1, 2022, and December 31, 2022. Prescriptions were filled within one regional division of a large community-based pharmacy chain, encompassing 71 pharmacies within Kansas, Nebraska, and Missouri. This retrospective observational cohort analysis examined prescription fill data for antihyperglycemic medications for the calendar year 2022 across one regional division of a large community-based pharmacy chain. Included patients 65 years of age or older with a Medicare prescription drug plan, using any basal insulin and any GLP-1RA, including combinations, as well as metformin, with ≥ 80% proportion of days covered. Demographics, usage predictors, and cost differences were compared between patients using individual products and those using insulin/GLP-1RA combination products. A total of 138 patients were analyzed. The use of insulin/GLP-1RA combination products was associated with increased likelihood of using sodium-glucose cotransporter-2 inhibitors ( = 0.022). Median annual out-of-pocket spending was significantly different between groups ( < 0.001), with most combination users paying more than $1,000 less per year than individual product users. Insulin/GLP-1RA combination products represent a cost-effective alternative to individual antidiabetic pharmacotherapy agents.
2022年，联邦法律将医疗保险处方药计划受益人的胰岛素产品成本上限设定为每月35美元。然而，该法律并未解决其他抗高血糖药物的高成本问题，如胰高血糖素样肽-1受体激动剂（GLP-1RAs），其平均每月自付费用为120美元。根据该法律，固定比例的胰岛素/GLP-1RA组合产品被归类为“胰岛素产品”，使这些有效的药物对于那些可能买不起的患者更容易获得。患者可能没有意识到组合产品的潜在经济益处，这凸显了识别使用这些产品的患者以更好地教育患者和医疗服务提供者的必要性。主要目标是确定胰岛素/GLP-1RA组合产品使用的预测因素。次要目标是确定单独使用产品的患者和使用组合产品的患者在药物成本上是否存在差异，并确定换药的成本节约潜力。这是一项回顾性观察队列分析。对2022年1月1日至2022年12月31日期间开具的抗高血糖药物的处方配药数据进行了检查。处方在一家大型社区连锁药店的一个区域分部内配药，该分部包括堪萨斯州、内布拉斯加州和密苏里州的71家药店。这项回顾性观察队列分析检查了2022日历年一家大型社区连锁药店一个区域分部内抗高血糖药物的处方配药数据。纳入的患者为65岁及以上且有医疗保险处方药计划，使用任何基础胰岛素和任何GLP-1RA（包括组合产品）以及二甲双胍，且覆盖天数比例≥80%。比较了使用单独产品的患者和使用胰岛素/GLP-1RA组合产品的患者的人口统计学、使用预测因素和成本差异。共分析了138名患者。使用胰岛素/GLP-1RA组合产品与使用钠-葡萄糖协同转运蛋白-2抑制剂的可能性增加相关（ = 0.022）。两组之间的年度自付费用中位数存在显著差异（ < 0.001），大多数使用组合产品的患者每年的自付费用比使用单独产品的患者少1000多美元。胰岛素/GLP-1RA组合产品是单独抗糖尿病药物治疗剂的一种具有成本效益的替代方案。
