GLP-1RA Dispensing in Youth With Type 2 Diabetes: 2020 to 2023
Abstract
Objective: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are a novel pharmacotherapeutic option for pediatric type 2 diabetes (T2D); however, little is known about their current use. This study evaluated trends in GLP-1RA dispensing in youth with T2D between 2020 and 2023 and compared use by insurance type (ie, Medicaid vs commercial).
Methods: We conducted a multiyear cross-sectional study of youth aged 10 to 17 years with T2D using Merative™ MarketScan® Multi-State Medicaid and Commercial Database claims and encounters data (2020-2023). Annual prevalence of GLP-1RA dispensing was calculated for each year. Temporal trends in dispensing were examined using the Cochran-Armitage test. Poisson regression with robust variance estimated adjusted prevalence ratios (aPRs) were used to evaluate associations between insurance type (ie, Medicaid vs commercial) and GLP-1RA dispensing in 2023.
Results: Annual prevalence of GLP-1RA dispensing in youth with T2D increased from 10.9% in 2020 to 35.6% in 2023 (P value for trend < .001) but remained less frequent than long- (49.5%) and short-acting insulin (43.4%). In 2023, overall GLP-1RA dispensing was similar for Medicaid-insured and commercially insured youth; however, the types of GLP-1RA differed by insurance. Medicaid-insured youth were less likely than commercially insured youth to be dispensed semaglutide (aPR 0.3, 95% CI: 0.2-0.4) and more likely to be dispensed dulaglutide (aPR 1.5, 95% CI: 1.2-2.0), exenatide (aPR 2.3, 95%…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.
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