Real-World Temporal and Indication-Specific Variation in Drivers of GLP-1 RA Discontinuation
Author(s)
Brianna Cartwright, MS, Patricia J. Rodriguez, MPH, PhD, Duy Do, PhD, Nick Stucky, MD, PhD;
Truveta, Inc, Truveta Research, Bellevue, WA, USA
Truveta, Inc, Truveta Research, Bellevue, WA, USA
Presentation Documents
OBJECTIVES: Patients receiving glucagon-like peptide-1 receptor agonists (GLP-1 RAs) has increased; however, there are high discontinuation rates. Little is known about variation in discontinuation reasons by indication and changes over time. We explored discontinuation reasons.
METHODS: Using a subset of electronic health record data from Truveta from June 2021 to August 2024, we identified patients with a GLP-1 RA prescription fill and a reported discontinuation reasons (data were extracted from clinical notes using natural language processing). If multiple discontinuation events were reported, only the last was included. Patients were excluded if they received a prescription fill within 60 days after discontinuation or the indication (anti-diabetic [ADM] or anti-obesity [AOM]) was unknown. Chi-squared tests were used to assess group differences, and we describe changes over time.
RESULTS: We included 52,485 people (62.8% female, 72.1% white, 79.2% not Hispanic or Latino, and mean (SD) 57.9(14.3) years of age). Most (93.1%) received ADMs. Discontinuation reasons differed between ADM and AOM users (p≤0.001). Side effects were the most common discontinuation reason for both groups, however ADM users reported higher rates than AOM users (31.4% vs. 22.6%). AOM users cited medication availability (6.9% vs. 2.2%) and no longer needing the medication (14.8% vs. 9.8%) more frequently than ADM users. Discontinuation due to AOM availability peaked at 10.3% in 2023Q3 but has since decreased to 7.3% in 2024Q2 (discontinuation due to ADM availability in 2023Q3: 2.1%). Discontinuation due to ADM side effects and cost remained stable, but in 2024, more AOM users stopped due to cost (17.0%) compared to ADM users (13.9%).
CONCLUSIONS: We found variation in GLP-1 RA discontinuation reasons by indication. ADM users cited side effects at higher rates than AOM users, while AOM users were more affected by medication unavailability, emphasizing the need for tailored strategies to address each group's specific barriers to continued use.
METHODS: Using a subset of electronic health record data from Truveta from June 2021 to August 2024, we identified patients with a GLP-1 RA prescription fill and a reported discontinuation reasons (data were extracted from clinical notes using natural language processing). If multiple discontinuation events were reported, only the last was included. Patients were excluded if they received a prescription fill within 60 days after discontinuation or the indication (anti-diabetic [ADM] or anti-obesity [AOM]) was unknown. Chi-squared tests were used to assess group differences, and we describe changes over time.
RESULTS: We included 52,485 people (62.8% female, 72.1% white, 79.2% not Hispanic or Latino, and mean (SD) 57.9(14.3) years of age). Most (93.1%) received ADMs. Discontinuation reasons differed between ADM and AOM users (p≤0.001). Side effects were the most common discontinuation reason for both groups, however ADM users reported higher rates than AOM users (31.4% vs. 22.6%). AOM users cited medication availability (6.9% vs. 2.2%) and no longer needing the medication (14.8% vs. 9.8%) more frequently than ADM users. Discontinuation due to AOM availability peaked at 10.3% in 2023Q3 but has since decreased to 7.3% in 2024Q2 (discontinuation due to ADM availability in 2023Q3: 2.1%). Discontinuation due to ADM side effects and cost remained stable, but in 2024, more AOM users stopped due to cost (17.0%) compared to ADM users (13.9%).
CONCLUSIONS: We found variation in GLP-1 RA discontinuation reasons by indication. ADM users cited side effects at higher rates than AOM users, while AOM users were more affected by medication unavailability, emphasizing the need for tailored strategies to address each group's specific barriers to continued use.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EPH85
Topic
Epidemiology & Public Health
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)