Diabetes Medications
Includes insulin, GLP-1 receptor agonists, SGLT2 inhibitors, DPP-4 inhibitors, and metformin. The highest-growth drug class by Medicare spending.
How Diabetes Medications Work
Metformin reduces liver glucose production ($4/month generic). GLP-1 agonists (Ozempic, Trulicity) mimic gut hormones to stimulate insulin release and reduce appetite. SGLT2 inhibitors (Jardiance, Farxiga) block glucose reabsorption in kidneys. DPP-4 inhibitors (Januvia) enhance the body's own incretin hormones. Insulin directly replaces what the body can't produce.
Diabetes Medications — Ranked by Cost Per Claim (Cheapest First)
| # | Drug | Generic Name | Cost/Claim | Generic? |
|---|---|---|---|---|
| 1 | Basaglar | Insulin Glargine (biosimilar) | $130.00 | No |
| 2 | Lantus | Insulin Glargine | $136.00 | Yes |
| 3 | NovoLog | Insulin Aspart | $139.00 | Yes |
| 4 | Humalog | Insulin Lispro | $142.00 | Yes |
| 5 | Jardiance | Empagliflozin | $210.00 | Yes |
| 6 | Januvia | Sitagliptin | $219.00 | No |
| 7 | Toujeo | Insulin Glargine U-300 | $254.00 | Yes |
| 8 | Tresiba | Insulin Degludec | $262.00 | Yes |
| 9 | Farxiga | Dapagliflozin | $266.00 | Yes |
| 10 | Rybelsus | Semaglutide (oral) | $428.00 | Yes |
| 11 | Trulicity | Dulaglutide | $473.00 | No |
| 12 | Mounjaro | Tirzepatide | $673.00 | No |
| 13 | Ozempic | Semaglutide | $685.00 | No |
Potential Savings
Metformin ($4/month) remains the first-line treatment for Type 2 diabetes. Newer GLP-1 agonists cost $400-900/month but Medicare has negotiated Ozempic down to $274/month starting 2027 — a 71% discount.
First-line generic: metformin at $4.00/claim. Ask your doctor if this is appropriate for you.
Key Facts
- 1.37.3 million Americans have diabetes (11.3% of the population)
- 2.GLP-1 agonists (Ozempic, Mounjaro) are the fastest-growing drug class by spending — up 72.5% YoY
- 3.Medicare negotiated 2027 prices for Ozempic ($274/mo), Jardiance ($197/mo), and Januvia ($113/mo)
- 4.Insulin prices capped at $35/month for Medicare beneficiaries since 2023
- 5.Total Medicare diabetes drug spending exceeds $20B annually
Frequently Asked Questions
The cheapest option is Metformin (generic Glucophage) at $4 per claim. Metformin ($4/month) remains the first-line treatment for Type 2 diabetes. Newer GLP-1 agonists cost $400-900/month but Medicare has negotiated Ozempic down to $274/month starting 2027 — a 71% discount.
Metformin reduces liver glucose production ($4/month generic). GLP-1 agonists (Ozempic, Trulicity) mimic gut hormones to stimulate insulin release and reduce appetite. SGLT2 inhibitors (Jardiance, Farxiga) block glucose reabsorption in kidneys. DPP-4 inhibitors (Januvia) enhance the body's own incretin hormones. Insulin directly replaces what the body can't produce.
All spending data comes from the CMS Medicare Part D Drug Spending Dashboard. Patent and generic information comes from the FDA Orange Book. Prices shown are average cost per 30-day supply claim under Medicare Part D.