The Real-World Costs of GLP-1 Receptor Agonist Treatment

Abstract Background The high cost and widespread use of glucagon-like peptide 1 receptor agonists (GLP-1RAs) are a concern for healthcare budgets. Whether GLP-1RA use reduces other health care spending is unclear. Methods We conducted a cohort study using insurance claims data for United States adults aged 18-64 from 2016-2024, matching GLP-1RA treated members with untreated members (controls) on baseline demographics, clinical conditions, hospitalization, and medication use. Primary outcomes were per member per month (PMPM) healthcare costs overall and by service type, analyzed separately for members with and without diabetes. Results Among 742,824 matched treated and control members, 55.6% had diabetes. In year 1 following GLP-1RA initiation, total costs were 68.7% higher in treated members (95% CI, 68.0%-69.4%, $743 PMPM difference); in years 2-6 costs were 44.8% higher (95% CI, 43.7%-45.9%; $530 PMPM difference). Excluding GLP-1RA costs, treated members had 5.8% higher costs in year 1 (95% CI 5.1%-6.5%) and 4.1% higher costs (95% CI 3.0% - 5.2%) in years 2-6. Among treated members with diabetes, cost increases were modest: 3.8% (95% CI 2.8% - 4.8%) in year 1 and 0.8% in years 2-6 (95% CI 0.6%-2.2%), with non-GLP-1RA pharmacy and provider visits offset by reduced admissions and dialysis. Treated members without diabetes had more substantial cost increases: 8.9% in year 1 (95% CI 7.7% - 10.1%) and 9.7% in years 2-6 (95% CI 8.0% - 11.4%). Conclusions GLP-1RA treatment was associated with increases in spending on healthcare net of the GLP-1RA cost, particularly in members without diabetes. Key Points Question What are the real-world costs of GLP-1 receptor agonist (GLP-1RA) treatment for adults with diabetes and other conditions? Findings GLP-1RAs treatment is associated with substantially increased healthcare costs. Excluding the costs of GLP-1RAs, treated adults with diabetes have modest increases in costs; however, those treated without diabetes have costs that are.9% higher than those not receiving the drug. Meaning Medical costs of using GLP-1RAs for those without diabetes go far beyond the costs of the agents. An estimated 40% of the US adult population are eligible for treatment for obesity. Treating them with GLP-1RAs would have a substantial impact on insurance costs.