Home delivered, medically tailored groceries improve diabetes control
Kaiser Permanente
PASADENA, Calif. (July 21, 2026)—A study from researchers at top US health insurance and medical services provider Kaiser Permanente, the Food is Medicine Institute at the Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University and The George Institute for Global Health found medically tailored grocery deliveries improved blood sugar control among adults living with type 2 diabetes who have public health insurance, when compared with usual care. The findings show that integrating Food is Medicine approaches into clinical care can improve both diabetes outcomes and food and nutrition security for patients. The study is published in the journal Circulation.
“This trial shows that food-based support can help patients with low incomes lower their blood sugar levels above and beyond the health care they receive. said the study’s lead author, Claudia Nau, PhD, a researcher with Kaiser Permanente Southern California Department of Research & Evaluation. “Our findings suggest that addressing access to healthy food can play a meaningful role in diabetes care for patients, particularly those facing economic and social barriers.”
The study was a randomized controlled trial conducted within Kaiser Permanente Southern California to examine whether medically tailored grocery deliveries could improve blood sugar control among adults with type 2 diabetes. Researchers enrolled 460 Medicaid insured patients with persistently elevated blood sugar levels who were receiving care at 12 medical office buildings across Southern California. Participants were recruited between November 2021 and July 2022 and followed for six months.
Participants were randomly assigned to receive usual care or one of two monthly amounts of medically tailored groceries (averaging about $135 or $175) paired with support, which included weekly home deliveries of healthy foods scaled to household size, culturally tailored recipes, and access to phone based nutrition counseling. Researchers compared changes in blood sugar and food related outcomes using electronic health records and participant surveys.
Key findings include:
- Participants who received medically tailored groceries had greater improvements in blood sugar than those receiving usual care, with an additional 0.40 point reduction in HbA1c over six months.
- Among those who received groceries, the odds of food security increased by nearly 215 percent and nutrition security increased by 365 percent.
- Blood sugar improvements were similar whether participants received the higher or lower level of medically tailored groceries.
The findings add to the growing Food is Medicine literature by providing evidence in a randomized controlled trial that medically tailored grocery programs can improve both clinical outcomes and food related conditions that influence health. By focusing on a Medicaid insured population with persistently poor glycemic control, the study helps fill an evidence gap and supports the integration of food-based interventions into routine diabetes care.
“These trial results further demonstrate that healthy food can be a powerful tool in treatment and management of chronic disease,” said senior author Dr. Dariush Mozaffarian, cardiologist and director of the Food is Medicine Institute at the Friedman School at Tufts. “Incorporating Food is Medicine programs, like medically tailored groceries, into Medicaid benefits recognizes nutrition as a fundamental component of health and can lead to better patient outcomes.”
“For too long nutrition has been an afterthought in healthcare, despite poor diets driving immense disease burden and healthcare costs globally - not just in the United States,” said Dr Jason Wu, Head of Nutrition Science at The George Institute for Global Health and a co-Principle Investigator for the trial. “Beyond informing local policies – such as those for health systems and payers designing Food is Medicine benefits – hopefully this study will also be a catalyst for policymakers to begin investing in, and testing similar programs worldwide.”
Funding/disclosures: Funding by Kaiser Permanente Community Health
About Kaiser Permanente:
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America's leading health care providers and not-for-profit health plans. Founded in 1945, Kaiser Permanente has a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve 12.9 million members in 9 states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal Permanente Medical Group physicians, specialists, and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery, and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education, and the support of community health. For more information, go to about.kp.org.
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Journal
Circulation
Article Title
Effects of a “Food is Medicine” Intervention on Glucose Control among Medicaid-Insured Patients with Type 2 Diabetes: A Randomized Controlled Trial
Article Publication Date
21-Jul-2026
Availability of generic semaglutide removes barrier to affordable diabetes care, experts predict
Calculations in the Canadian Journal of Cardiology provide evidence of cost-effectiveness of therapies for patients with type 2 diabetes and high cardiorenal risk
Elsevier
July 22, 2026 – In a novel analysis examining the economic implications of generic semaglutide entering the Canadian market, researchers predict that the anticipated price reductions of up to 70% will dramatically increase both the cost-effectiveness and health system affordability of therapy options for patients with type 2 diabetes and high cardiorenal risk. The new study in the Canadian Journal of Cardiology, published by Elsevier, provides key evidence regarding reimbursement and formulary decisions.
Generic semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1RA), has recently become available in Canada after regulatory exclusivity for semaglutide expired in Canada in January 2026—years earlier than expected in the US and countries in Europe. Patients with type 2 diabetes and high cardiorenal risk are recommended to initiate a GLP-1RA and/or a sodium-glucose cotransporter-2 inhibitor (SGLT2i) according to Canadian and international guidelines.
The authors estimate that between 1.3 and 2.1 million people living in Canada may meet the Canadian Cardiovascular Society criteria for type 2 diabetes patients eligible to use GLP-1RAs or SGLT2is. The estimated annual cost of providing GLP-1RAs to all indicated patients would be $3.35 to $5.31 billion at pre-generic 2025 semaglutide prices. In Canada, these costs are typically paid by provincial or private drug insurance plans, but may be paid out-of-pocket when the drugs are not covered by a patient’s insurance plan.
“The high cost of brand-name versions of these GLP-1RAs has been a significant barrier to patients and provincial insurers. Anticipated price reductions from the introduction of generic semaglutide could substantially alter the health economic value of programs aimed at initiating SGLT2i and GLP-1RA therapies for patients with type 2 diabetes and high cardiorenal risk,” says first author of the study Ethan McNally, BA, McGill University School of Population and Global Health.
Using a health economic microsimulation model to project lifetime costs, quality-adjusted life years (QALYs), and the burden of cardiovascular and renal comorbidities for this high-risk patient group, the investigators examined how the cost-effectiveness of GLP-1RAs changes across a range of possible prices.
Key Economic Modeling Outcomes
Guided by the commonly used threshold of $50,000 per QALY in Canada, the most important findings are as follows:
- At a 60% reduction from the 2025 pre-generic semaglutide price paid by the Quebec provincial drug plan, combined GLP-1RA and SGLT2i therapy may become the preferred strategy for this guideline-indicated cohort of patients, compared to either therapy alone or other standard-of-care therapies.
- At a 70% price reduction, GLP-1RA is predicted to be cost-effective compared to non-SGLT2i standard-of-care therapies (cost-effectiveness ratio [CER] of $22,700). SGLT2i is still predicted to be preferred over GLP-1RA alone, but dual therapy is predicted to be more cost-effective than either option alone (CER of $31,700 for dual therapy vs. SGLT2i alone).
Given the rapid growth of GLP-1RA usage and their high costs, this analysis may provide evidence for reimbursement and formulary decisions. “Many provincial public drug plans limit GLP-1RA and SGLT2i reimbursement to patients who fail to meet glycemic targets. Multiple clinical guidelines now recommend these therapies for patients with type 2 diabetes at high cardiorenal risk, regardless of blood sugar levels. Given that our findings suggest that generic pricing may be cost-effective, payers could explore adjusting reimbursement criteria,” notes lead investigator Abhinav Sharma, MD, PhD, DREAM-CV Lab, Research Institute, and Centre for Outcome Research & Evaluation, McGill University Health Centre.
These findings may generalize internationally, once generic semaglutide becomes available in other countries.
Co-lead investigator Alton Russell, PhD, McGill University School of Population and Global Health, and Centre for Outcome Research & Evaluation, McGill University Health Centre, concludes, “Our results are encouraging and provide further economic justification for the use of these therapies among appropriate patients with type 2 diabetes in Canada, which will significantly improve the quality of life, lower hospitalization costs, and ultimately protect patients from heart failure and kidney disease progression.”
Journal
Canadian Journal of Cardiology
Method of Research
Data/statistical analysis
Subject of Research
Not applicable
Article Title
Implications of Generic Semaglutide Availability on the Cost-Effectiveness of GLP-1RA for Guideline-Indicated Patients With Type 2 Diabetes
Article Publication Date
22-Jul-2026
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