Table 9.2

Median monthly cost of maximum approved daily dose of noninsulin glucose-lowering agents in the U.S.

ClassCompound(s)Dosage strength/product (if applicable)Median AWP (min, max)Median NADAC (min, max)Maximum approved daily dose*
Biguanides• Metformin500 mg (IR)$84 ($4, $93)$22,000 mg
850 mg (IR)$108 ($6, $109)$32,550 mg
1,000 mg (IR)$87 ($4, $88)$22,000 mg
500 mg (ER)$89 ($82, $6,671)$4 ($4, $1,267)2,000 mg
750 mg (ER)$72 ($65, $92)$41,500 mg
1,000 mg (ER)$1,028 ($1,028, $7,214)$311 ($311, $1,321)2,000 mg
Sulfonylureas (2nd generation)• Glimepiride4 mg$71 ($71, $198)$48 mg
• Glipizide10 mg (IR)$75 ($67, $97)$540 mg (IR)
10 mg (XL)$48$1520 mg (XL)
• Glyburide6 mg (micronized)$50 ($48, $71)$1012 mg (micronized)
5 mg$93 ($63, $103)$1320 mg
Thiazolidinediones• Pioglitazone45 mg$348 ($283, $349)$445 mg
• Rosiglitazone4 mg$407$3298 mg
α-Glucosidase inhibitors• Acarbose100 mg$106 ($104, $106)$23300 mg
• Miglitol100 mg$241$311300 mg
Meglitinides (glinides)• Nateglinide120 mg$155$46360 mg
• Repaglinide2 mg$878 ($162, $898)$4816 mg
DPP-4 inhibitors• Alogliptin25 mg$234$17025 mg
• Saxagliptin5 mg$490 ($462, $490)$3925 mg
• Linagliptin5 mg$494$3955 mg
• Sitagliptin100 mg$516$413100 mg
SGLT2 inhibitors• Ertugliflozin15 mg$322$25715 mg
• Dapagliflozin10 mg$557$44610 mg
• Canagliflozin300 mg$558$446300 mg
• Empagliflozin25 mg$558$44825 mg
GLP-1 receptor agonists• Exenatide (extended release)2 mg powder for suspension or pen$792$6342 mg**
• Exenatide10 μg pen$850$68020 μg
• Dulaglutide1.5/0.5 mL pen$876$7021.5 mg**
• Semaglutide1 mg pen$875$7041 mg**
• Liraglutide18 mg/3 mL pen$1,044$8351.8 mg
Bile acid sequestrants• Colesevelam625 mg tabs$712 ($674, $712)$3543.75 g
3.75 g suspension$674$5983.75 g
Dopamine-2 agonists• Bromocriptine0.8 mg$855$6854.8 mg
Amylin mimetics• Pramlintide120 μg pen$2,547$2,036120 μg/injection†††
  • AWP, average wholesale price; DPP-4, dipeptidyl peptidase 4; ER and XL, extended release; GLP-1, glucagon-like peptide 1; IR, immediate release; NADAC, National Average Drug Acquisition Cost; SGLT2, sodium–glucose cotransporter 2.

  • Calculated for 30-day supply (AWP [44] or NADAC [45] unit price × number of doses required to provide maximum approved daily dose × 30 days); median AWP or NADAC listed alone when only one product and/or price.

  • * Utilized to calculate median AWP and NADAC (min, max); generic prices used, if available commercially.

  • ** Administered once weekly.

  • ††† AWP and NADAC calculated based on 120 μg three times daily.