Table 9.2

Median monthly (30-day) 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, $85)$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 ($87, $7,412)$5 ($5, $988)2,000 mg
750 mg (ER)$74 ($65, $74)$41,500 mg
1,000 mg (ER)$242 ($242, $7,214)$224 ($224, $910)2,000 mg
Sulfonylureas (2nd generation)• Glimepiride4 mg$74 ($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)$412 mg (micronized)
5 mg$93 ($63, $103)$1120 mg
Thiazolidinediones• Pioglitazone45 mg$348 ($283, $349)$445 mg
• Rosiglitazone4 mg$407$3308 mg
α-Glucosidase inhibitors• Acarbose100 mg$106 ($104, $106)$23300 mg
• Miglitol100 mg$241$311300 mg
Meglitinides (glinides)• Nateglinide120 mg$155$39360 mg
• Repaglinide2 mg$878 ($162, $897)$3916 mg
DPP-4 inhibitors• Alogliptin25 mg$234$16825 mg
• Saxagliptin5 mg$505$4035 mg
• Linagliptin5 mg$523$4195 mg
• Sitagliptin100 mg$541$433100 mg
SGLT2 inhibitors• Ertugliflozin15 mg$338$27115 mg
• Dapagliflozin10 mg$591$47310 mg
• Empagliflozin25 mg$591$47325 mg
• Canagliflozin300 mg$593$475300 mg
GLP-1 RAs• Exenatide (extended release)2 mg powder for suspension or pen$840$6722 mg**
• Exenatide10 µg pen$876$73020 µg
• Dulaglutide1.5/0.5 mL pen$911$7301.5 mg**
• Semaglutide1 mg pen$927$7451 mg**
14 mg (tablet)$927N/A14 mg
• Liraglutide18 mg/3 mL pen$1,106$8861.8 mg
• Lixisenatide300 µg/3 mL pen$744N/A20 µg
Bile acid sequestrant• Colesevelam625 mg tabs$712 ($674, $712)$1773.75 g
3.75 g suspension$675$4153.75 g
Dopamine-2 agonist• Bromocriptine0.8 mg$906$7294.8 mg
Amylin mimetic• Pramlintide120 µg pen$2,623$2,097120 µg/injection†††
  • AWP, average wholesale price; DPP-4, dipeptidyl peptidase 4; ER and XL, extended release; GLP-1 RA, glucagon-like peptide 1 receptor agonist; IR, immediate release; N/A, data not available; NADAC, National Average Drug Acquisition Cost; SGLT2, sodium–glucose cotransporter 2.

  • Calculated for 30-day supply (AWP [54] or NADAC [55] 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.