According to the Centers for Disease Control and Prevention (CDC), an estimated 25.8 million people in the United States have diabetes. Diabetes is the leading cause of kidney failure, nontraumatic lower-limb amputation, and new cases of blindness. Although health plans are mostly eager to offer wide formulary access to therapies for diabetes as a result of this huge need, greater inter-brand competition both within and across drug classes and the generic entry of several key brands will allow health plans more opportunities to design formularies for type 2 diabetes with a focus on drug cost.