Costs for Diabetic Patients Receiving Dipeptidyl Peptidase-4 (DPP-4) Inhibitors in US Medicare and Commercial Insurance Plans.

Dipeptidyl peptidase-4 (DPP-4) inhibitors are a newer class of oral hypoglycemic medications which prevent the breakdown of incretin, resulting in decreased glucagon levels and increased insulin release, thereby reducing blood glucose. This medication class is primarily indicated for management of type 2 diabetes as either monotherapy or in combination with other oral hypoglycemic agents.1-4 There are four DPP-4 inhibitors presently available in the US: sitagliptin marketed as Januvia, saxagliptin marketed as Onglyza, linagliptin marketed as Tradjenta, and alogliptin marketed as Nesina. A systematic review showed that adding a DPP-4 inhibitor may be more cost-effective than other medication combinations in patients whose diabetes is not well controlled on monotherapy.5 However, direct cost comparisons using claims data are lacking.