Cost Limited Kidney Drug Access Between 2019 and 2024
Nephrologists report that high costs hindered the use of protective medications for patients with diabetes and kidney disease.
Updated on Oct. 8, 2026 in Diabetes
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Between 2019 and 2024, nephrology providers identified high costs as the primary barrier to prescribing cardio-kidney protective medications. A recent survey conducted from April to June 2025 captured the prescribing challenges faced by clinicians managing patients with stage 3 chronic kidney disease and type 2 diabetes.
Why it matters
Providers report that cost obstacles impede the delivery of optimal care, potentially impacting patient access to treatments that reduce hospitalizations. Researchers suggest that transitioning to value-based payment models may be necessary to improve access to these therapies.
In a survey of 61 nephrology providers conducted in 2025, respondents reported that between 2019 and 2024, only 40% of patients with stage 3 CKD and type 2 diabetes used SGLT2 inhibitors, while usage of GLP1 RAs and nsMRAs remained lower.
The details
The survey identified significant disparities in prescribing habits, with 93% of providers comfortable with SGLT2 inhibitors but half never having prescribed a GLP1 RA. Cost serves as a primary hurdle for these medication classes, which are designed to offer cardiovascular and renal protection. Authors distributed the anonymous survey through professional networks to analyze the disconnect between clinical guidelines and real-world prescribing.
Timeline
Between 2019 and 2024, patients utilized these cardio-kidney protective medications.
Authors conducted the provider survey from April to June 2025.
Health Landscape
The clinical management of chronic kidney disease and type 2 diabetes increasingly relies on cardio-kidney protective therapies to improve long-term outcomes. This study highlights that provider-reported financial barriers continue to limit the adoption of these standardized treatments.
If you are managing stage 3 chronic kidney disease and type 2 diabetes, you may wish to discuss available medication options and potential insurance coverage questions with your physician. Understanding the barriers to these specialized treatments can help you and your care team navigate your options.
The takeaway
Clinicians cite cost as a significant deterrent to using modern, protective medications for chronic kidney disease. If you are exploring new treatment paths for diabetes and kidney health, ask your doctor about the affordability and access considerations for specific drug classes.
What happens next
Study authors are planning future in-depth qualitative interviews with patients, providers, and payers to further explore these access challenges.
Further reading
For more on managing long-term kidney health, visit our Diabetes section.
Source note: This article includes information reported by Ajmc.
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