2358-P: Utilization and Persistence of Weight Management Therapies among Adults with Type 2 Diabetes (T2D) and Obesity

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)