Trends in the Prescribing and Dispensing of GLP-1 Anti-Obesity Medications Among U.S. Adults with Cardiovascular Disease and Overweight or Obesity, 2021-2024
Author(s)
Duy Do, PhD1, Karthik Murugiah, MBBS2, Mitsuaki Sawano, MD2, Patricia J. Rodriguez, MPH, PhD1, Brianna Cartwright, MS1, Lesley Curtis, PhD3, Nick Stucky, MD, PhD1.
1Truveta, Incorporated, Bellevue, WA, USA, 2Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT, USA, 3Departments of Population Health Sciences and Medicine, Duke University School of Medicine, Durham, NC, USA.
1Truveta, Incorporated, Bellevue, WA, USA, 2Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT, USA, 3Departments of Population Health Sciences and Medicine, Duke University School of Medicine, Durham, NC, USA.
Presentation Documents
OBJECTIVES: This study assessed trends in prescribing and dispensing of glucagon-like peptide-1 (GLP-1) anti-obesity medications (AOM) among U.S. adults with cardiovascular disease (CVD) and overweight or obesity from 2021 to 2024. It also explored the association between the FDA’s approval of AOM semaglutide for CVD risk reduction in March 2024 and AOM prescribing and dispensing, particularly semaglutide, tirzepatide, and liraglutide.
METHODS: Using a subset of electronic health record data from Truveta, we analyzed trends in AOM prescribing and dispensing from January 2021 to October 2024. Interrupted time series analyses with Poisson regression and autoregressive integrated moving average models examined the association between FDA’s approval and prescribing/dispensing patterns. All analyses adjusted for age, sex, race, and ethnicity.
RESULTS: The population included 1,092,427 adults aged 18+ with CVD (myocardial infarction, stroke, or peripheral artery disease) and BMI ≥ 27 with no prior GLP-1 prescribing/dispensing. In March 2024, prescribing (dispensing) rates per 100,000 persons were 144.0 (38.5), 102.0 (42.0), and 4.7 (0.4) for AOM semaglutide, tirzepatide, and liraglutide, respectively. Prescribing (incidence rate ratio [IRR], 1.59; 95% CI, 1.45-1.75) and dispensing (IRR, 2.26; 95% CI, 1.97-2.59) of AOM semaglutide significantly increased in April 2024 following FDA approval, but both rates declined or leveled off afterward. Prescribing (IRR, 0.54; 95% CI, 0.45-0.64) and dispensing (IRR, 0.59; 95% CI, 0.50-0.71) of AOM tirzepatide immediately decreased post-expansion. No immediate changes were observed for AOM liraglutide.
CONCLUSIONS: The expansion of AOM semaglutide’s indication was followed by an immediate rise in its prescribing and dispensing. However, the decline in both prescribing and dispensing of AOM semaglutide following this surge raises the possibility that additional factors, such as insurance coverage, cost, shortages, or compounded AOMs, may play an important role in shaping long-term treatment patterns. Further research is needed to understand the long-term impacts on medication access and patient outcomes.
METHODS: Using a subset of electronic health record data from Truveta, we analyzed trends in AOM prescribing and dispensing from January 2021 to October 2024. Interrupted time series analyses with Poisson regression and autoregressive integrated moving average models examined the association between FDA’s approval and prescribing/dispensing patterns. All analyses adjusted for age, sex, race, and ethnicity.
RESULTS: The population included 1,092,427 adults aged 18+ with CVD (myocardial infarction, stroke, or peripheral artery disease) and BMI ≥ 27 with no prior GLP-1 prescribing/dispensing. In March 2024, prescribing (dispensing) rates per 100,000 persons were 144.0 (38.5), 102.0 (42.0), and 4.7 (0.4) for AOM semaglutide, tirzepatide, and liraglutide, respectively. Prescribing (incidence rate ratio [IRR], 1.59; 95% CI, 1.45-1.75) and dispensing (IRR, 2.26; 95% CI, 1.97-2.59) of AOM semaglutide significantly increased in April 2024 following FDA approval, but both rates declined or leveled off afterward. Prescribing (IRR, 0.54; 95% CI, 0.45-0.64) and dispensing (IRR, 0.59; 95% CI, 0.50-0.71) of AOM tirzepatide immediately decreased post-expansion. No immediate changes were observed for AOM liraglutide.
CONCLUSIONS: The expansion of AOM semaglutide’s indication was followed by an immediate rise in its prescribing and dispensing. However, the decline in both prescribing and dispensing of AOM semaglutide following this surge raises the possibility that additional factors, such as insurance coverage, cost, shortages, or compounded AOMs, may play an important role in shaping long-term treatment patterns. Further research is needed to understand the long-term impacts on medication access and patient outcomes.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
HPR108
Topic
Health Policy & Regulatory
Topic Subcategory
Approval & Labeling
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory), SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)