Diabetes incidence is rising in the US, with more than 40 million US residents living with this condition. Diabetes morbidity and mortality are unequally distributed, and new diagnoses are higher among American Indian/Alaska Native, Black, and Hispanic adults, compared with White adults. Managing prescription medications is critical to reducing diabetes morbidity, as is controlling risk factors and associated comorbid conditions. However, the cost of pharmacologic therapy has increased substantially, driven in part by the growing use of newer glucose-lowering agents. The high cost of these medications comprises a substantial portion of diabetes-related health care expenditure for individuals with diabetes and may result in restrictive coverage by health plans insuring enrollees with diabetes, further limiting access to care. The out-of-pocket costs faced by patients are particularly burdensome, because patients also face the consequences of adverse downstream outcomes that result from reduced medication adherence due to costs.