OBJECTIVES: Characteristics of patients prescribed new medications often evolve over time after their market launch. To explore this, our analysis described baseline demographic and clinical characteristics as well as antidiabetic medication use in T2DM patients initiating oral semaglutide from its introduction in the US in a commercially-insured/Medicare Advantage population.

METHODS: Patients with T2DM newly initiating oral semaglutide between 9/20/2019-8/31/2020 were identified using the HealthCore Integrated Research Database in quarterly segments (index as first claim). Patients were included with at least 1 pharmacy claim for oral semaglutide during the study period, 90 days or more of pre-index and post-index enrollment, 1 or more HbA1c laboratory test results, and 1 or more claim with a diagnosis for type 2 diabetes.

RESULTS: Four quarterly refreshes were included, totaling 2,763 T2DM patients. Endocrinologists were the largest group of early prescribers of semaglutide (34.7% at baseline) but decreased in later cohorts (21.9% at last refresh) and proportion of primary care physician prescribers increased over time (33.1% to 43.6%). The most common anti-diabetic medications, prior to oral semaglutide initiation, included metformin and sodium-glucose cotransporter-2 (SGLT2) inhibitors, with no changes over time. The most common non-anti-diabetic medications included antihypertensives, lipid lowering therapy, and antidepressants, with antihypertensive use rates increasing over time and antidepressants decreasing. Most patients had an HbA1c level above 7% (roughly 70%), increasing to roughly 80% in the last cohort. The most common comorbidities at index included hypertension, dyslipidemia, hyperglycemia, obesity, and sleep apnea, with these trends also staying stable except for hyperglycemia, which decreased over time.

CONCLUSION: After launch, the population initiating oral semaglutide experienced changes in demographic, clinical characteristics, and baseline treatment experience. It is important to understand and monitor the evolving characteristics of these patients, ensuring they have access to the appropriate medications they require at the time they need it most.