Presentation (CTI)

OBJECTIVES: Liraglutide (Saxenda®) is reimbursed by the Health Service Executive (HSE) in Ireland subject to a Managed Access Protocol (MAP). The MAP utilises an outcomes-based reimbursement approach, whereby initial reimbursement support is approved for six months based on a patient’s diagnosis and clinical characteristics at the time of application, and continued reimbursement support is contingent on a subsequent application demonstrating treatment outcomes in terms of weight loss. This study evaluates persistence with liraglutide for weight management in adult patients accessing treatment through HSE community drugs schemes.
METHODS: Persistence was defined as the duration of time from treatment initiation until discontinuation (defined as a gap of greater than 60 days beyond the expected end date of the previous claim). Data to inform this study was from the HSE national pharmacy claims database, and analyses included patient claims across all community drug schemes. Patients with at least one claim for liraglutide between January 2024 and December 2025 were included in the study. Persistence was assessed from the index date until discontinuation, censoring, or study end; those without discontinuation within 18 months were censored at last supply date or 31 December 2025, whichever came first. Kaplan-Meier survival analyses were used to estimate the time to treatment discontinuation. Analyses were conducted in R.
RESULTS: The study included n=9,965 patients. Mean persistence was 79.1% (95% CI: 78.3-80.0%) at 6 months (n=6,428), 49.8% (95% CI: 48.7-51.0%) at 12 months (n=3,016) and 39.8% (95% CI: 37.6-40.0%) at 18 months (n=1,669).
CONCLUSIONS: There was a notable reduction in persistence with liraglutide over time. While consistent with international real-world data, this may also be explained in part by the MAP's outcomes-based reimbursement approach.