Glucagon-like peptide-1 receptor agonists (GLP-1 RA) are preferred injectable therapies for type 2 diabetes, but it is uncertain if advantages justify higher medication cost. This real-world, retrospective cohort study at eight ambulatory care sites evaluated change in monthly glucose-lowering medication cost, HbA1c, weight and polytherapy at GLP-1 RA initiation (baseline) and after 6-12 months (follow-up). The population was analyzed as a whole and as subgroups based on baseline medication regimen and demographics.

Results: The study population (n=120) was 67.5% female, age 55.8±11.7 years, obese, 71% minority, equal English and non-English speaking, had high pill and injection burden, and baseline HbA1c 10%. Figure 1 summarizes changes in monthly glucose-lowering medication costs. Overall change in HbA1c was -1.7%, p<0.001. This decrease was consistent in each baseline medication regimen subgroup. Weight decreased overall (-1.8kg, p<0.001), and there was a significant shift to taking fewer oral agents and insulin as well as fewer daily injections, but no meaningful differences were noted when stratified by age (<65 or ≥65 years), gender, English vs. non-English speaking, or race.

Conclusion: Although a positive impact resulted in glycemic control, weight, and reducing polytherapy 6-12 months after adding a GLP-1 RA to the medication regimen, the increase to monthly medication cost will serve as a barrier to treatment.


M. Jacobs: None. T. Rose: None. D.J. Reid: None. C. Bouwmeester: None. M. Conley: None. B. Fatehi: None. T.M. Matta: None. J. Barr: None.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at