A new study led by UCLA Health found that a large percentage of disadvantaged patients are not taking their diabetes medications consistently. The analysis, which combed the national health records of 587,000 Medicare Advantage patients, showed Black and Hispanic patients were less likely than White patients to adhere to their medication protocols.
The research, published in JAMA Network Open, analyzed national health data from 2019. Overall, adherence to diabetes medications was less than 60 percent. The study also found that extra assistance programs – specifically Medicaid and Medicare's Part D Low-Income Subsidy – significantly helped reduce those treatment gaps, particularly for high-cost treatments like insulin and newer drugs such as SGLT2 inhibitors and GLP-1 RAs.
"Taking diabetes medications consistently is critical for preventing serious, long-term health complications," said lead author Dr. Utibe R. Essien , an associate professor-in-residence of medicine in the David Geffen School of Medicine at UCLA's division of general internal medicine and health services research.
"Healthcare providers need to recognize that health plan rules and out-of-pocket costs strongly affect whether patients take their medications. Clinicians can help patients connect with financial support programs to make sure essential diabetes treatments are affordable and accessible," Essien said.
Patients in the study were considered "adherent" if at least 80 percent of days were covered. Medications evaluated were metformin, insulin and a combined group of SGLT2 inhibitor and GLP-1 RA therapies.
Researchers were surprised to find that Black patients had significantly lower adherence to metformin, compared to White patients (46 percent vs. 56.5 percent) even though metformin in a low-cost, widely available drug.
"Non-financial factors play a role here," Essien said. "Future research must pinpoint specific obstacles – such as pharmacy closures, dosing complexity, side effects or personal beliefs about treatment – so targeted programs can better support high-risk communities."
More than 34 million people in the United States have a diagnosis of type 2 diabetes; 1 in 4 people 65 and older have been diagnosed. Black and Hispanic adults have 47 percent and 31 percent higher rates of diabetes than White adults, respectively.
