Study Finds Similar Short-Term Costs for GLP-1RA Responders and Nonresponders Despite Low A1c Response Rates
A new real-world analysis presented at AMCP 2025 found that only 38% of patients with diabetes had an A1c response after initiating glucagon-like peptid-1 receptor agonist (GLP-1RA) therapy, yet health care costs in the 180-day follow-up period were similar between responders and nonresponders.
Using deidentified administrative claims from the Optum Labs Data Warehouse, the study identified 55 835 commercially insured and Medicare Advantage patients who began GLP-1RA treatment between July 2017 and June 2023. Eligible patients were 18 years old or older, had baseline A1c ≥7.0%, and maintained continuous enrollment over the 180-day pre- and post-treatment periods. A1c response was defined as achieving A1c <7.0% at 91 to 180 days post-treatment.
Of the cohort, 38% were classified as responders and 62% as nonresponders. Responders had a mean baseline A1c of 8.5% and achieved 6.3% by follow-up. Nonresponders started at 9.2% and remained at 8.4%. “While A1c response was low (38% of patients), health care costs were similar for responders and non-responders in the 180 days after initiating GLP-1RA,” the authors reported.
More responders continued GLP-1RA therapy at 91 to 180 days (81% vs 66%; standardized mean difference [SMD], 0.33) and had lower use of non-GLP-1RA diabetes treatments (78% vs 87%; SMD, 0.25). In contrast, nonresponders more often used additional therapies both at baseline and during follow-up. Despite differences in treatment response, total follow-up health care costs were nearly identical: $14 735 (±$22 358) for responders vs $14 328 (±$18 746) for nonresponders (SMD, 0.02). Pharmacy and medical costs were also comparable.
These findings offer early insights for developing pharmacogenomic testing models to predict GLP-1RA treatment response. The authors note the need for longer-term data: “Further research is needed to assess costs for responders and non-responders over a longer follow-up and adjust for baseline characteristics.”
Reference
Stockl K, Tucker J, Morin P. Treatment response and health care costs in the 180-day period after glucagon-like peptide-1 receptor agonist (GLP-1RA) initiation in patients with diabetes. Presented at: AMCP 2025; March 31-April 3; Houston, TX.
