Cost-Effectiveness of DPP-4 Inhibitors in Diabetes Care

Cost Comparison

The American Diabetes Association's Standards of Medical Care in Diabetes reports that alogliptin (25 mg) has a monthly cost of $234 AWP/$170 NADAC, while saxagliptin (5 mg) costs $490 AWP/$392 NADAC, linagliptin (5 mg) costs $494 AWP/$395 NADAC, and sitagliptin (100 mg) costs $516 AWP/$413 NADAC per month 1
More recent data (2024) shows that the costs have increased, with alogliptin (25 mg) costing $234 AWP/$161 NADAC, saxagliptin (5 mg) costing $524 AWP/$466 NADAC, linagliptin (5 mg) costing $630 AWP/$504 NADAC, and sitagliptin (100 mg) costing $657 AWP/$525 NADAC per month 2

The American Diabetes Association recommends starting with metformin as the initial medication for type 2 diabetes due to its low cost ($2-4 per month) and established cardiovascular benefits 1, 3
Alogliptin is considered the most affordable DPP-4 inhibitor option for second-line therapy, with a monthly cost of $170 NADAC for the maximum daily dose of 25 mg 1, 2

The monthly cost difference between the least expensive (alogliptin) and most expensive (sitagliptin) DPP-4 inhibitor is approximately $243 per month based on 2019 data, which translates to over $2,900 per year in potential savings 1