RACIAL/ETHNIC AND SOCIOECONOMIC DISPARITIES IN THE UTILIZATION OF GLP-1RA AND SGLT2I AMONG US ADULTS WITH TYPE 2 DIABETES BY CARDIOVASCULAR AND RENAL DISEASE INDICATIONS (2018-2019)

Abstract

Newer glucose-lowering drugs (GLP-1RA, and SGLT2i) are expensive with high cost-sharing. This would lead to racial and socioeconomic disparities and inequities but has never been proved. This study aims to examine the racial/ethnic and socioeconomic disparities in the utilization of newer drugs among type 2 diabetes with a history of cardiovascular disease, renal disease, or at high cardiovascular disease risk in the US. We conducted a cross-sectional study, using the MEPS database from 2018 to 2019. We enrolled adults with type 2 diabetes and have indication for benefit drugs use. Multivariable logistic regression was used to investigate the use of newer drugs among the eligible population by indications. A total of 3305 individuals with diabetes were identified, among whom 1391 had CVD, 379 had CKD, and 2996 had a higher risk of ASCVD. Non-Hispanic Asian (OR 0.43, 95%CI 0.20-0.92), and non-Hispanic Black (OR 0.62, 95%CI 0.42-0.91) were associated with lower probability of using GLP-1RA/SGLT2i compared to non-Hispanic White. Compared to high-income individuals, near poor (OR 0.56, 95%CI 0.33-0.96) and low income (OR 0.61, 95%CI 0.39-0.95) had a lower probability of using benefit drugs. Compared to privately insured, publicly insured participants (OR 0.65, 95%CI 0.48-0.89) were associated with a lower probability use of benefit drugs. In conclusion, there were an association between lower use of GLP-1RA/SGLT2i among patients with indication and racial/ethnicity, and lower socioeconomic status. Policymakers' interventions are needed to ensure equitable access of GLP-1RA/SGLT2i for the potential undertreatment in population racial/ethnic and socioeconomic subgroups.