Assessing Accessibility & Affordability of Novel Diabetes Treatments 

Injections for weight loss with Semaglutide. An obese woman gives a hormone glucagon-like peptide-1 (GLP-1) injection into the abdomen with a pen syringe.

Problem

The rapid rise in spending on new diabetes medications is straining health care affordability in California and contributing to uneven access across the state. 

Prescription drug costs in California are rising faster than inflation, with newer diabetes treatments such as GLP-1 receptor agonists playing a significant role in this trend. These medications, while clinically beneficial, are among the most expensive and frequently prescribed drugs in the state. As insurers absorb these costs, they often pass them on to consumers through higher premiums and out-of-pocket expenses. In 2023 alone, prescription drugs accounted for over 15 percent of insurance premiums in California, up from the previous year.

At the same time, access to these medications is not consistent across the population. Utilization patterns vary widely depending on factors such as insurance type, geographic location, and patient demographics. People with lower incomes and those enrolled in public insurance programs are less likely to receive these treatments, raising concerns about the consistency and fairness of access. These patterns suggest that the financial burden of new diabetes therapies is not only growing but also unevenly distributed, highlighting the need for a clearer understanding of how these drugs are being prescribed and paid for across California.

Solution

NORC will use California’s all-payer claims data to examine access and affordability of diabetes treatments. 

With support from the California Health Care Foundation (CHCF), NORC will conduct a comprehensive analysis of utilization and costs for GLP-1s and other diabetic drugs among adults with type 2 diabetes using the HPD, a rich source of claims and encounter data across both commercial payers and Medi-Cal. The study will use descriptive statistics, regression modeling, and geospatial mapping to examine how access and affordability vary by patient, provider, and geographic characteristics. NORC will also link HPD data with external sources to enhance the analysis. The results will be publicly disseminated to support evidence-based decision-making by policymakers, payers, and providers.

Result

The project will generate actionable insights to support more affordable and accessible diabetes care. 

NORC expects this research to highlight important differences in how Californians access and pay for novel diabetes medications. By identifying patterns in utilization and costs, the study will help stakeholders understand where targeted interventions may be needed. The findings will support CHCF’s broader efforts to improve health care affordability and access in California and may serve as a model for similar research in other states. 