Traditional drug spend spotlight: Diabetes

Diabetes tops the list of highest traditional drug spend. Diabetes spend is predominantly driven by glucagon-like peptide-1 (GLP-1) utilization, which is projected to grow over 350% by 2027.

Mounjaro® dominates GLP-1 spend

Mounjaro® outpaced Ozempic® with 432% year-over-year trend due to more promising outcomes and a reduced side effect profile. In addition, there was an anticipated shift in drug mix illustrated by a 14% trend decrease of Trulicity® and similar 44% trend decrease for Victoza® due to lower weight loss potential.

Insulin spend decreases as GLP-1 spend increases

Insulin and oral DPP-4 medication experienced negative trends with decreased utilization while GLP-1 injectables had a 50% trend primarily driven by anticipated new script volume. Changes in prescribing guidelines led to increased utilization and trend increases in continuous glucose monitors such as Dexcom CGM (91% per member per month [PMPM] trend).

Diabetes spend outlook for 2025

Upcoming changes in guideline recommendations are expected to affect healthcare spending. Additionally, a broader range of therapies is now recommended for first-line diabetes treatment, offering the potential for improved patient outcomes but often at a higher cost compared to generic options.

To see more drug trends and insights, visit the Insights Hub.

Read more

• A look forward: Five trends PBMs should expect in 2025
• One size does not fit all: GLP-1 weight loss coverage options for three companies

References

• IPD Analytics (2024) 2024 Updates to American Diabetes Association Guidelines: Cost Impact, January 2024
• American Diabetes Association Professional Practice Committee; Summary of Revisions: Standards of Care in Diabetes — 2024. Diabetes Care