Use of Second-Generation Antidiabetic Medication Among a Nationally Representative Sample

OBJECTIVES: Existing studies have shown the benefits of second -generation antidiabetic medications in patients with type 2 diabetes (T2D). However, the medications' real -world utilization was not well understood. Our study assessed patient factors associated with the use of second -generation antidiabetic medications in a nationally representative sample of patients with T2D. STUDY DESIGN: This retrospective, cross-sectional analysis used the 2005 to 2018 National Health and Nutrition Examination Survey (NHANES) data. METHODS: Survey participants 18 years and older who had a diagnosis of T2D and had used antidiabetic medications in the past 30 days were included. The primary outcome was the prescription of any second -generation antidiabetic medication. Weighted stepwise multivariable logistic regression models were used to assess the associations between the use of second -generation antidiabetic medications and patients' characteristics. RESULTS: Among 4493 patients with T2D, 533 (weighted %, 13.67%) reported using at least 1 second -generation antidiabetic drug. In multivariable analyses, patients with incomes at least 400% of the federal poverty level (adjusted odds ratio [AOR], 2.30; 95% CI, 1.58-3.34), with higher hemoglobin A1c levels (AOR, 1.10; 95% CI, 1.02-1.18), and taking more medications (AOR, 1.14; 95% CI, 1.09-1.20) were more likely to use second -generation antidiabetic drugs compared with their counterparts. CONCLUSIONS: The uptake of second -generation antidiabetic medications was 14% among patients with T2D in the United States. Prescription benefit design that targets lower out-of-pocket payments for these newer drugs may improve patient access and clinical outcomes for patients with T2D.