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

METHODS: T2DM patients initiating subcutaneous semaglutide between 2/1/2017-3/31/2020 were identified using HealthCore Integrated Research Database in quarterly segments (index as first claim). Patients were included with ≥1 year of pre-index enrollment and ≥1 T2DM claim. Patients were stratified based on prior glucagon-like peptide 1 receptor agonist (GLP-1) use (experienced/naïve). Baseline demographic, clinical and antidiabetic medication use characteristics were descriptively reported.

RESULTS: Eight quarterly refreshes were included, totaling 31,031 T2DM patients (20,272 GLP-1 naïve, 10,759 GLP-experienced). Most patients in both groups were prescribed semaglutide by endocrinologists at baseline, with this trend slowly decreasing over time and PCPs becoming the primary prescribers during later quarters. The most common anti-diabetic medications in both groups, prior to subcutaneous semaglutide initiation, were metformin (77.6% at baseline) and sodium-glucose cotransporter-2 (SGLT2) inhibitors (41.3%), with SGLT2 inhibitor rates slowly decreasing. Most patients had HbA1c levels above 7% in both groups (66.2-74.0% GLP-1 experienced patients, 73.7-83.5% GLP-1 naïve), with no significant trends. Non-anti-diabetic medications prescribing rates were high in both groups, including antihypertensives (79.9-81.7%) and lipid lowering therapy (71.9-73.7%). Roughly 34% of patients were prescribed antidepressants (35.5% among GLP-1 experienced, 32.9% GLP-1 naïve). The most common comorbidities included hypertension, dyslipidemia, hyperglycemia, obesity, and sleep apnea, with trends also staying stable.

CONCLUSION: After launch, the T2D population initiating subcutaneous semaglutide experienced changes in baseline demographics, clinical characteristics, and antidiabetic treatment use. Continuous monitoring of these trends ensures that, as these provider types and patient subgroups evolve, prescribing healthcare practitioners have the most up-to-date and relevant information to managing T2DM.