A new study led by UCLA Health, published in JAMA Network Open. Analyzed 2019 national health records of 587,000 Medicare Advantage patients:
Main Findings:
- Overall adherence to diabetes medications was less than 60%. Patients were considered “adherent” if at least 80% of days were covered.
- Black and Hispanic patients were less likely than White patients to adhere to medication protocols.
- For metformin specifically, Black patients had significantly lower adherence than White patients — 46% vs. 56.5% — despite metformin being low-cost and widely available.
Medications Evaluated: metformin, insulin, and a combined group of SGLT2 inhibitors and GLP-1 RAs.
Role of Financial Assistance:
- Assistance programs — Medicaid and Medicare’s Part D Low-Income Subsidy — significantly helped reduce treatment gaps.
- The effect was most pronounced for high-cost treatments like insulin and newer drugs such as SGLT2 inhibitors and GLP-1 RAs.
Author Statements:
Lead author Dr. Utibe R. Essien, associate professor-in-residence at UCLA’s David Geffen School of Medicine, said consistent medication use is critical for preventing long-term complications, and that health plan rules and out-of-pocket costs strongly affect adherence. He said clinicians can help connect patients with financial support programs, and noted that non-financial factors — such as pharmacy closures, dosing complexity, side effects, or personal beliefs about treatment — may explain disparities in low-cost drugs and require further research.