Introduction and Objective: Contemporary patterns of long-term pharmacologic management of comorbid obesity and T2D remain poorly defined. Despite the benefits of GLP-1 drugs, utilization is limited by cost, shortages, and tolerability. This study characterizes 12-year trends of anti-obesity medication (AOM) use. Methods: Using claims from Optum Labs Data Warehouse, we identified adults with T2D and obesity between 2013-2024, subset to commercial vs Medicare Advantage (MA) insurance, captured fills for older AOMs (naltrexone/bupropion, phentermine, phentermine/topiramate) and GLP-1 drugs (liraglutide, oral semaglutide, subcutaneous semaglutide, tirzepatide), quantified time-on-treatment, and examined treatment patterns. Results: We identified 1,279,904 adults with T2D and obesity; 40.5% with commercial insurance and 59.5% with MA. Older AOMs were used rarely (1%), while subcutaneous semaglutide was most used (Figure). Median time-on-treatment for GLP-1 drugs was 280 IQR 489 days in commercial and 246 347 days in MA plans, while for older AOMs it was 121 245 days in commercial and 213.5 347 days in MA plans. Patients treated with GLP-1 drugs either stopped treatment or transitioned to another GLP-1; switching to older AOMs was negligible. Conclusion: GLP-1 drugs are the main pharmacologic treatment of obesity in T2D, with longer treatment persistence than older AOMs. Disclosure A. Singh: None. R. Zhang: None. P.D. Wartko: Research Support; Ended; Syneos Health (representing a consortium of pharmaceutical companies that manufacture opioids). C. Chen: None. J.F. Bobb: None. E. Johnson: None. C.A. Begle: None. P. OConnor: None. L.C. Ross: None. D. Arterburn: None. R. McCoy: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health (NIH) (R01DK135515)
SINGH et al. (Fri,) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: