Skip to main content
U.S. flag

An official website of the United States government

Official websites use .gov
A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS
A lock ( ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.

Beta This is a new resource - your feedback will help us improve it.

Series: Audits of Diabetes Drugs Under Medicare Part D

Announced on  | Last Modified on  | Series Number: SRS-A-26-010
Status
Active
Agency
Centers for Medicare and Medicaid Services

OBJECTIVE

In 2022, six type 2 diabetes drugs accounted for more than half of all Medicare Part D payments for diabetes drugs. Diabetes drugs are meant to lower blood sugar levels and often result in weight loss. Part D spending for one of these six drugs, Ozempic, more than tripled between 2020 and 2022, with expenditures jumping from $1.5 billion to $4.6 billion. Other diabetes drugs are experiencing similar growth and could overshadow Ozempic. Part D payments for a type 2 diabetes drug, such as Ozempic, for a use that Medicare does not cover as a medically accepted indication is not in compliance with Medicare requirements and presents an opportunity for fraudulent, excessive, or unnecessary Part D payments. Furthermore, drugs that are used for weight loss are specifically excluded from Medicare Part D coverage. We will obtain Part D data for prescribed diabetes drugs and any related Part B service claims. We will determine whether they were billed according to Medicare requirements.

There are 3 projects in this series.

Project titles will remain unpublished until projects are complete and reports are posted.

ACTIVE PROJECTS IN THIS SERIES (2)

Project WA-24-0035 • Announced on Mar 15, 2024

Project OAS-26-05-003 • Announced on Oct 14, 2025

COMPLETED PROJECTS IN THIS SERIES (1)

Medicare Part D Spending for Selected Diabetes Drugs in 2023

Project A-05-24-00015 • Completed on February 21, 2025

TIMELINE

  • March 4, 2024
    Project Announced

    Medicare Part D Spending for Selected Diabetes Drugs in 2023 - A-05-24-00015

  • March 15, 2024
    Series Number SRS-A-26-010 Assigned
  • March 15, 2024
    Project Announced

    Project WA-24-0035

  • February 21, 2025
    Project Complete - A-05-24-00015

    Medicare Program Oversight has been marked as complete. Report Published

  • October 14, 2025
    Project Announced

    Project OAS-26-05-003

  • Today
    2 Projects In-Progress
  • Est FY2026
    Estimated Fiscal Year for Series Completion

1 REPORT PUBLISHED

Medicare Part D Spending for 10 Selected Diabetes Drugs Totaled $35.8 Billion in 2023, an Increase of 364 Percent From 2019 (A-05-24-00015)

This data brief presents information about trends in national Medicare spending on and utilization of 10 selected diabetes drugs. For this data brief, we have identified that Medicare Part D spending on these 10 selected diabetes drugs increased by 364 percent, from $7.7 billion in 2019 to $35.8 billion in 2023. During the same time, there was an increase in prescriptions and prescribers who work in a broad range of specialties. Meanwhile, the number of Medicare Part D enrollees increased 12 percent, from 44.9 million to 50.5 million. We estimated that Medicare spending for the 10 selected diabetes drugs could reach $102 billion by 2026.

No recommendations were issued as a part of this report.
Work Plan Type
Office of Audit Services
HHS Agencies
Centers for Medicare and Medicaid Services
Issue Areas
Departmental Operational Issues Financial Stewardship Food, Drug and Device Safety Prescription Drug Public Health Issues
Target Groups
-
Financial Groups
Medicare D