Cost-Effectiveness of DPP-4 Inhibitors for Medicare Patients

Cost Comparison

The American Diabetes Association's cost data shows that alogliptin is the least expensive DPP-4 inhibitor, costing $234 AWP/$161 NADAC per month for the maximum daily dose of 25 mg, representing a potential annual savings of approximately $2,900 when chosen over the most expensive option, sitagliptin, for Medicare patients with Blue Cross supplement 1
The 2022 American Diabetes Association guidelines confirm alogliptin as the lowest-cost DPP-4 inhibitor option 2

For Medicare patients with a Blue Cross supplement, out-of-pocket costs will depend on the phase of coverage, the specific Blue Cross supplement plan's formulary tier placement of each medication, and whether the patient qualifies for Low-Income Subsidy (LIS) programs 2
Alogliptin is most likely to have the lowest out-of-pocket cost regardless of coverage phase due to its lowest base price 1

Verify that the patient has tried metformin first, as it remains the first-line therapy due to its low cost ($2-4 per month) and established cardiovascular benefits, before considering alogliptin as add-on therapy 1
If a DPP-4 inhibitor is clinically appropriate, choose alogliptin as the most cost-effective option, and check the specific Blue Cross supplement plan's formulary to confirm tier placement and any prior authorization requirements 1, 2

Prices may vary between pharmacy networks, and it's worth checking for special pricing agreements for specific DPP-4 inhibitors 2
The listed prices (AWP and NADAC) do not account for discounts, rebates, or other price adjustments that may affect the actual cost incurred by the patient 2