Ann Intern Med

Medicaid barriers limit access to cardioprotective drugs for patients with T2DM

April 24, 2025

Study details: This national cross-sectional study assessed the unrestricted availability of sodium-glucose cotransporter-2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in Medicaid programs, using dipeptidyl peptidase-4 inhibitors (DPP4is) as a benchmark. The study included all 50 state Medicaid fee-for-service (FFS) plans and 273 managed care organization (MCO) plans as of March 2024.

Results: FFS plans had greater unrestricted availability than MCO plans for the following: SGLT2is (80% vs. 67%), GLP-1 RAs (60% vs. 48%), and DPP4is (84% vs. 75%). Availability increased from 2020 to 2024, especially in FFS plans, but GLP-1 RA availability under MCO plans have plateaued at <60% since 2022.

Clinical impact: The availability of cardioprotective medications varies significantly for type 2 diabetes across Medicaid plans, with MCO plans showing more restrictions, particularly for GLP-1 RAs. This variability suggests a need for policy interventions to improve access to these medications, which are crucial for reducing cardiovascular risk in patients with T2DM.

Source:

Makam AN, et al. (2025, April 22). Ann Intern Med. Availability of Cardioprotective Medications for Type 2 Diabetes in the Medicaid Program. https://pubmed.ncbi.nlm.nih.gov/40258281/