REAL-WORLD ADHERENCE TO GLP-1RA AND DUAL GIP-GLP-1RA AMONG COMMERCIALLY INSURED US PATIENTS WITH TYPE 2 DIABETES AND OBESITY
Author(s)
Bernard Bright Davies-Teye, MPH, MD, PhD, Hannah Mei, PharmD, MS, Kimberly O’Malley, MS, PMP, Chintan Dave, PharmD, PhD;
Rutgers University, New Brunswick, NJ, USA
Rutgers University, New Brunswick, NJ, USA
OBJECTIVES: Glucagon-like peptide-1 receptor agonists (GLP-1RA) are increasingly prescribed for type 2 diabetes (T2D) and weight management; however, adverse effects, particularly gastrointestinal, may limit tolerability and real-world adherence. Newer dual GIP/GLP-1 RAs are hypothesized to improve tolerability, yet real-world evidence comparing adherence across agents and metabolic indications remains limited. Accordingly, this study evaluated real-world adherence to GIP/GLP-1 RAs among US commercially insured adults with T2D, and overweight or obesity.
METHODS: Adults aged 18-64 years were identified in two indication-specific cohorts: patients with T2D initiating GLP-1RA or dual GIP/GLP-1RA, and patients with obesity without T2D initiating weight-loss-approved agents. Adherence was assessed at 12 months using proportion of days covered (PDC), summarized by mean PDC and the proportion achieving PDC≥0.80, overall and by agent. Analyses were conducted separately by cohort. To address imbalances in baseline characteristics across the initiated agents, multinomial propensity score-based inverse probability of treatment weights (IPTW) were estimated.
RESULTS: In the T2D cohort (N= 323,584), 29.8% (95% CI: 29.6%-30.0%) of patients achieved a PDC≥0.80. After IPTW adjustment, adherence was highest for dulaglutide (35.8%, 95% CI: 35.4%-36.1%), followed by semaglutide (26.7%, 95% CI: 26.5%-26.9%), and tirzepatide (23.4%, 95% CI: 22.8%-24.0%), with corresponding mean PDCs of 58.4%, 53.0%, and 48.5%, respectively. In the obesity cohort (N=162,484), adherence was substantially lower, with PDC≥0.80 achieved by 10.0% (95% CI: 9.7%-10.3%) for liraglutide, 15.9% (95% CI: 15.7%-16.2%) for semaglutide, and 13.9% (95% CI: 13.3%-14.5%) for tirzepatide, and mean PDCs of 36.4%, 43.6%, and 41.9%, respectively.
CONCLUSIONS: Findings are limited by unmeasured drug shortages and formulary restrictions on annual or lifetime maximums. Among commercially insured adults, real-world adherence to GLP-1RA or dual GIP/GLP-1RA was low overall and particularly poor among patients treated for obesity.
METHODS: Adults aged 18-64 years were identified in two indication-specific cohorts: patients with T2D initiating GLP-1RA or dual GIP/GLP-1RA, and patients with obesity without T2D initiating weight-loss-approved agents. Adherence was assessed at 12 months using proportion of days covered (PDC), summarized by mean PDC and the proportion achieving PDC≥0.80, overall and by agent. Analyses were conducted separately by cohort. To address imbalances in baseline characteristics across the initiated agents, multinomial propensity score-based inverse probability of treatment weights (IPTW) were estimated.
RESULTS: In the T2D cohort (N= 323,584), 29.8% (95% CI: 29.6%-30.0%) of patients achieved a PDC≥0.80. After IPTW adjustment, adherence was highest for dulaglutide (35.8%, 95% CI: 35.4%-36.1%), followed by semaglutide (26.7%, 95% CI: 26.5%-26.9%), and tirzepatide (23.4%, 95% CI: 22.8%-24.0%), with corresponding mean PDCs of 58.4%, 53.0%, and 48.5%, respectively. In the obesity cohort (N=162,484), adherence was substantially lower, with PDC≥0.80 achieved by 10.0% (95% CI: 9.7%-10.3%) for liraglutide, 15.9% (95% CI: 15.7%-16.2%) for semaglutide, and 13.9% (95% CI: 13.3%-14.5%) for tirzepatide, and mean PDCs of 36.4%, 43.6%, and 41.9%, respectively.
CONCLUSIONS: Findings are limited by unmeasured drug shortages and formulary restrictions on annual or lifetime maximums. Among commercially insured adults, real-world adherence to GLP-1RA or dual GIP/GLP-1RA was low overall and particularly poor among patients treated for obesity.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
PT38
Topic
Patient-Centered Research
Topic Subcategory
Adherence, Persistence, & Compliance
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity), STA: Biologics & Biosimilars, STA: Multiple/Other Specialized Treatments, STA: Personalized & Precision Medicine