Evidence mapPaperPMID 41984414Full record

ArticleJournal of general internal medicine2026

Trends in GLP-1 Receptor Agonist and SGLT2-Inhibitor Utilization and Expenditure Between 2017-2023: Demographic, Income, and Insurance Associations.

Molly Jacobs, Qianqian Fang, Charles Ellis

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Article in Journal of general internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Molly JacobsDepartment of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA. mollyjacobs@ufl.edu.ORCID http://orcid.org/0000-0001-5943-8507
Qianqian FangDepartment of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA.
Charles EllisDepartment of Speech, Language and Health Science, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite the proven effectiveness of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium glucose transporter-2 inhibitors (SGLT2-Is) for the treatment of a variety of conditions, the complexity of factors that influence access and utilization patterns is poorly understood.

objectiveUsing data from the 2017-2023 Medical Expenditure Panel Survey (MEPS), this study quantified GLP-1 RA/SGLT2-I utilization, expenditure, and off-label prescribing-defined as any prescription not linked to an FDA-approved indication-diabetes, chronic kidney disease, obesity, or cardiovascular disease-and estimated the determinants.

designSurvey-weighted logistic and generalized linear regression models, adjusted for demographic, insurance, time, and clinical characteristics, quantified these outcomes. KEY

resultsBetween 2017 and 2023, use of GLP-1 RAs/SGLT2-Is rose from 0.42 to 4.45% and from 8.50 to 31.36% among adults with an FDA-approved condition. Compared to Whites and those with high income, a college education, and private insurance, Blacks (OR = 0.78, CI = 0.62, 0.99), Hispanics (OR = 0.74, CI = 0.58, 0.94), middle-income (OR = 0.73, CI = 0.62,0.85) and low-income (OR = 0.73, CI = 0.61, 0.86) earners, publicly insured (OR = 0.79, CI = 0.55, 0.82), uninsured (OR = 0.53, CI = 0.31, 0.92), and those with low education (OR = 0.67, CI = 0.53, 0.85) were less likely to utilize GLP-1 RAs or SGLT2-Is. Simultaneously, per-prescription spending increased nearly 50%. Off-label utilization fell from 27 to 12%. Comparatively, off-label utilization was higher among females (OR = 1.56, CI = 1.08, 2.25), but lower among Blacks (OR = 0.92, CI = 0.53, 0.96), Hispanics (OR = 0.55, CI = 0.31, 0.95), and those with only a high school (OR = 0.66, CI = 0.43, 0.99) or less than high school (OR = 0.46, CI = 0.23, 0.90) education.

conclusionsThe use of GLP-1 RA and SGLT2-I increased between 2017 and 2023, especially among individuals with approved diagnoses. At the same time, the average per-prescription cost increased by nearly 50%, creating barriers to access among low-income/education individuals. Given their clinical benefits, policy efforts should focus on equitable access, cost containment, and guidance on off-label prescribing.

Indexed as

Glucagon-Like Peptide-1 Receptor AgonistsHealth ExpendituresInsurance, HealthSodium-Glucose Transporter 2 InhibitorsAdultAgedFemaleHumansIncomeMaleMiddle AgedOff-Label UseUnited StatesGlucagon-Like Peptide-1 Receptor AgonistsSodium-Glucose Transporter 2 InhibitorsGLP-1 receptor agonistsmedication expendituresoff-label prescribingSGLT2 inhibitorsutilization trends

Identifiers

PMID41984414
PMCPMC13421679

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.