Racial and ethnic disparities in medications provided to people with type 2 diabetes

Kaiser Permanente study finds people of most races and ethnic minorities are less likely to receive newer, safer types of drugs

A new type of drug used to treat type 2 diabetes has the dual benefit of keeping blood sugar levels stable and reducing the risk of heart and kidney disease, known complications of diabetes. But a new study from Kaiser Permanente shows there are racial and ethnic disparities in who is more likely to use these drugs.

The study, which evaluated pharmacy dispensing at six healthcare institutions nationwide, found that patients from certain racial and ethnic groups were less likely than white patients to be offered these new diabetes medications. The study results were presented March 19 at the American Heart Association. Epidemiology/Lifestyle Science Session 2024.

“Our study helps ensure more equitable use of new drugs among all racial and ethnic groups,” said lead author Julie Schmiddiel, Ph.D., associate director of health care delivery and policy in the Kaiser Permanente Research Division. This emphasizes the need to step up efforts to achieve this goal.”

The study included 687,165 adults with type 2 diabetes who were seen at six different healthcare facilities across the United States from 2014 to 2022. Researchers looked at prescriptions filled for two types of drugs: SGLT2 inhibitors and GLP-1 receptor agonists. These include SGLT2 inhibitors, such as Jardiance (empagliflozin) and Farxiga (dapagliflozin), and GLP-1 receptor agonists, such as Ozempic (semaglutide) and Byetta (exenatide).

The study found that American Indian/Alaska Native, Black, and Hispanic patients were less likely to receive SGLT2 inhibitors than white patients. Additionally, American Indian/Alaska Native, Asian, Black, Hawaiian or Pacific Islander, and Hispanic patients were less likely to receive GLP-1 receptor agonists than white patients. These racial and ethnic disparities persisted even after researchers took into account factors such as demographics, diabetes management, diabetes duration and control, additional health issues, and visits to specialists. Ta.

The six medical institutions surveyed were: Healthcare Systems Research Network They include Geisinger in Pennsylvania, HealthPartners in Minnesota and Wisconsin, Henry Ford Health in Michigan, Kaiser Permanente Northern California, Kaiser Permanente Southern California and Kaiser Permanente Hawaii. The researchers did not compare differences between health institutions.

The research team said future studies should aim to identify factors that may influence who receives these drugs. “Not all patients may have equal access to information about these medications or may not be equally comfortable asking their doctors about these medications.” said Dr. Luis A. Rodriguez, lead author and research associate in the department. . “We also don’t know whether the cost of the new drug contributed to our discovery, or whether some patients prefer to continue taking the pill rather than switching to a self-injectable GLP-1 receptor agonist. We need to know more about why this is happening.”

This study was supported by the Patient-Centered Outcomes Research Institute (PCORI) and the National Institute of Diabetes and Digestive and Kidney Diseases.

Co-authors include Dr. Holly Finertie, Dr. Andrew Karter, and Dr. Romain S. Neugebauer in the Department of Research. Bennett Gosiker, MHS, Kaiser Permanente School of Medicine; Dr. Tainaya W. Thomas, MPH, Stanford University; Lisa K. Gilliam, MD, of The Permanente Medical Group; Dr. Caryn Oshiro of Kaiser Permanente Hawaii; Dr. Jaejin Ahn of Kaiser Permanente Southern California; Dr. Gregg Simonson, HealthPartners Institute; Dr. Andrea E. Cassidy Bushlow of Henry Ford Health System; Sarah K. Dombrowski, PharmD, Geisinger. Margaret B. Nolan, MD, MS, and Patrick O’Connor, MD, MS, MPH of Health Partners Medical Education and Research Institute;

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About Kaiser Permanente Research Department

Kaiser Permanente’s Research Division conducts, publishes, and disseminates epidemiology and health services research to improve the health and health care of Kaiser Permanente members and society as a whole. We aim to understand the determinants of disease and health and improve the quality and cost-effectiveness of healthcare. Currently, his more than 600 staff members at DOR are working on his more than 450 epidemiology and health services research projects. For more information, visit divisionofresearch.kaiserpermanente.org or follow @KPDOR.