1674-P: Trends in Antidiabetic Medication Use among California Medicare Beneficiaries, 2013–2022

Introduction and Objective: Utilization patterns of anti-diabetic medications among U.S. older adults with diabetes remain incompletely characterized. This study aimed to examine temporal trends in anti-diabetic medication use from 2013-2022 among Medicare beneficiaries aged≥65 with diabetes, with a primary focus on California. Methods: Data was from CMS Medicare Beneficiary Summary File (2013-2022) covering 21 U.S. states, with California analyzed separately. This descriptive study included adults aged≥65 with diabetes who had 11-12 months Part A&B fee-for-service and Part D coverage each year. We examined the use of traditional anti-diabetic medications: metformin, sulfonylureas, insulin, thiazolidinediones, fixed-dose combinations, and newer agents: sodium-glucose cotransporter-2 inhibitors (SGLT2i), glucagon-like peptide-1 receptor agonists (GLP-1 RAs), and dipeptidyl peptidase-4 inhibitors (DPP-4i). Annual utilization rate for a medication class was defined as the proportion of adults filling 1+ prescriptions in that class during the year. Results: An average of 94,366 California adults with diabetes were identified annually. From 2013-2022, use of metformin, SGLT2i, and GLP-1 RAs increased, while insulin, sulfonylureas, fix-dose combinations, and DPP-4i declined (Figure 1). Conclusion: Our study demonstrates a substantial increase in use of newer anti-diabetic medications among U.S. older adults, reflecting their growing adoption in clinical practice.