{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T13:05:58Z","timestamp":1774098358954,"version":"3.50.1"},"reference-count":30,"publisher":"American Diabetes Association","issue":"11","license":[{"start":{"date-parts":[[2020,10,20]],"date-time":"2020-10-20T00:00:00Z","timestamp":1603152000000},"content-version":"vor","delay-in-days":46,"URL":"https:\/\/www.diabetesjournals.org\/content\/license"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,11,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>Certain antihyperglycemic therapies modify cardiovascular and kidney outcomes among patients with type 2 diabetes, but early uptake in practice appears restricted to particular demographics. We examine the association of Medicaid expansion with use of and expenditures related to antihyperglycemic therapies among Medicaid beneficiaries.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>We employed a difference-in-difference design to analyze the association of Medicaid expansion on prescription of noninsulin antihyperglycemic therapies. We used 2012\u20132017 national and state Medicaid data to compare prescription claims and costs between states that did (n = 25) and did not expand (n = 26) Medicaid by January 2014.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Following Medicaid expansion in 2014, average noninsulin antihyperglycemic therapies per state\/1,000 enrollees increased by 4.2%\/quarter in expansion states and 1.6%\/quarter in nonexpansion states. For sodium\u2013glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide 1 receptor agonists (GLP-1RA), quarterly growth rates per 1,000 enrollees were 125.3% and 20.7% for expansion states and 87.6% and 16.0% for nonexpansion states, respectively. Expansion states had faster utilization of SGLT2i and GLP-1RA than nonexpansion states. Difference-in-difference estimates for change in volume of prescriptions after Medicaid expansion between expansion versus nonexpansion states was 1.68 (95% CI 1.09\u20132.26; P &amp;lt; 0.001) for all noninsulin therapies, 0.125 (\u22120.003 to 0.25; P = 0.056) for SGLT2i, and 0.12 (0.055\u20130.18; P &amp;lt; 0.001) for GLP-1RA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Use of noninsulin antihyperglycemic therapies, including SGLT2i and GLP-1RA, increased among low-income adults in both Medicaid expansion and nonexpansion states, with a significantly greater increase in overall use and in GLP-1RA use in expansion states. Future evaluation of the population-level health impact of expanded access to these therapies is needed.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc20-0735","type":"journal-article","created":{"date-parts":[[2020,9,5]],"date-time":"2020-09-05T00:00:21Z","timestamp":1599264021000},"page":"2684-2690","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":22,"title":["Medicaid Expansion and Utilization of Antihyperglycemic Therapies"],"prefix":"10.2337","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5326-083X","authenticated-orcid":false,"given":"Andrew","family":"Sumarsono","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, University of Texas Southwestern Medical Center, and Division of Hospital Medicine, Parkland Memorial Hospital, Dallas, TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leo F.","family":"Buckley","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara R.","family":"Machado","sequence":"additional","affiliation":[{"name":"London School of Economics and Political Science, London, U.K."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rishi K.","family":"Wadhera","sequence":"additional","affiliation":[{"name":"Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haider J.","family":"Warraich","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA"},{"name":"Department of Medicine, Cardiology Section, VA Boston Healthcare System, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rishi J.","family":"Desai","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brendan M.","family":"Everett","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA"},{"name":"Division of Preventive Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6412-7989","authenticated-orcid":false,"given":"Darren K.","family":"McGuire","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Texas Southwestern Medical Center and Parkland Health and Hospital System, Dallas, TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregg C.","family":"Fonarow","sequence":"additional","affiliation":[{"name":"Ahmanson-UCLA Cardiomyopathy Center, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javed","family":"Butler","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Mississippi Medical Center, Jackson, MS"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9651-3836","authenticated-orcid":false,"given":"Ambarish","family":"Pandey","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Texas Southwestern Medical Center and Parkland Health and Hospital System, Dallas, TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0885-1953","authenticated-orcid":false,"given":"Muthiah","family":"Vaduganathan","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1167","published-online":{"date-parts":[[2020,9,4]]},"reference":[{"key":"2022031223505736600_B1","doi-asserted-by":"crossref","first-page":"S143","DOI":"10.1016\/j.amepre.2017.07.019","article-title":"Prevalence and medical costs of chronic diseases 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cardiovascular and renal outcomes in type 2 diabetes mellitus: a systematic review and meta-analysis of cardiovascular outcomes trials","volume":"139","author":"Zelniker","year":"2019","journal-title":"Circulation"},{"key":"2022031223505736600_B5","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/S0140-6736(18)32590-X","article-title":"SGLT2 inhibitors for primary and secondary prevention of cardiovascular and renal outcomes in type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials","volume":"393","author":"Zelniker","year":"2019","journal-title":"Lancet"},{"key":"2022031223505736600_B6","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1016\/S2213-8587(19)30249-9","article-title":"Cardiovascular, mortality, and kidney outcomes with GLP-1 receptor agonists in patients with type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials","volume":"7","author":"Kristensen","year":"2019","journal-title":"Lancet 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