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Monitoring Report: GLP-1 RA Prescribing Trends – June 2024 Data Snapshot

November 7, 2024

Insights into the Rising Popularity and Evolving Patterns of GLP-1 Receptor Agonist Medications

The healthcare landscape has witnessed a significant surge in the prescribing and usage of glucagon-like peptide 1 receptor agonist (GLP-1 RA) medications in recent years. These versatile pharmaceuticals, approved for both the management of type 2 diabetes (T2D) and weight loss in individuals with overweight or obesity, have captivated the attention of medical professionals and patients alike.

To provide a comprehensive understanding of the latest trends in GLP-1 RA prescribing, the Truveta Research team has meticulously analyzed real-world electronic health record (EHR) data from a collective of healthcare systems across the United States. This monitoring report offers a data-driven snapshot of the evolving landscape, shedding light on the key insights and implications for the IT and healthcare communities.

Surging Prescription Volumes and Changing Medication Preferences

The study period, spanning from January 2018 to June 2024, has witnessed a remarkable surge in the number of patients prescribed GLP-1 RA medications. The data reveals that a staggering 1,162,662 patients were prescribed these medications during this timeframe, with a total of 4,815,135 prescriptions recorded.

When analyzing the prescribing trends by medication type, several notable patterns emerge:

Anti-Diabetic Medications (ADMs) Remain Dominant

ADMs Account for the Majority: Among first-time prescriptions where the intended use could be established, ADMs accounted for a substantial 83.0% of the total, while anti-obesity medications (AOMs) represented the remaining 17.0%.
Semaglutide Leads the Pack: The most commonly prescribed first-time medication was semaglutide, with 644,272 patients receiving this ADM.
Tirzepatide Gains Ground: In late 2023, tirzepatide surpassed dulaglutide as the second most commonly prescribed ADM, showcasing the rapid adoption of this newer medication.

Anti-Obesity Medications (AOMs) on the Rise

AOM Prescribing Increases: AOM prescribing increased by 27.1% in June 2024 compared to March 2024, indicating a growing demand for these weight-loss focused medications.
Semaglutide Dominates AOM Prescriptions: Semaglutide was the most commonly prescribed AOM, followed by AOM tirzepatide. Interestingly, prescribing of AOM tirzepatide was observed in the first month of its availability in pharmacies, December 2023.

Shifting Patterns in First-Time Prescribing

The analysis also revealed intriguing trends in first-time prescribing rates for GLP-1 RA medications:

Overall Decline in First-Time Prescribing: First-time prescribing rates in June 2024 were slightly lower than the rates observed in March 2024, declining by 6.90%.
ADM First-Time Prescribing Decreases: First-time prescribing of ADMs decreased by 19.71% in June 2024 compared to March 2024.
AOM First-Time Prescribing Increases: In contrast, first-time prescribing of AOMs increased by 7.26% in June 2024 compared to March 2024.
Semaglutide Prescribing Slows: While overall prescribing of semaglutide increased throughout the second quarter of 2024, the rate of first-time prescribing slowed from 0.9% of prescriptions in May 2024 to 0.7% in June 2024. Similar declines were observed for ADM semaglutide, AOM semaglutide, and unknown semaglutide formulations.
Tirzepatide Prescribing Declines: New prescribing of tirzepatide decreased in each of the three months over the last quarter, suggesting a potential shift in medication preferences.

Medication Dispensing and Initiation Rates

The study also delved into the critical aspect of medication dispensing, which serves as a proxy for actual usage and initiation of GLP-1 RA treatments.

Overall Dispensing Rates: During the full study period, 73.7% of GLP-1 RA prescriptions were dispensed (filled) within 60 days of the prescription, indicating that the majority of patients initiated the medication within this timeframe.
ADM vs. AOM Dispensing: Among those with available data, 70.0% of first-time ADM prescriptions overall and 73.7% in March 2024 were dispensed within 60 days. In contrast, only 43.6% of first-time AOM prescriptions overall and 47.2% in March 2024 were dispensed within 60 days.
Initiation Rate Changes: Initiation rates for ADM GLP-1 RA increased slightly in March 2024 compared to December 2023 (+1.72%). However, initiation rates for AOM GLP-1 RA increased substantially during the same period, rising by 41.41%.

These insights into the evolving patterns of GLP-1 RA prescribing and dispensing provide valuable information for healthcare professionals, IT specialists, and policymakers. The data highlights the growing popularity of these medications, particularly for weight management, and the potential challenges in ensuring access and adherence, especially for patients seeking AOM prescriptions.

Implications and Future Considerations

The surge in GLP-1 RA prescribing reflects the increasing recognition of these medications’ therapeutic value, both for the management of type 2 diabetes and weight loss. However, the observed trends also raise important considerations for the IT and healthcare communities:

Monitoring and Data Tracking: The ability to leverage comprehensive, real-time data sources, such as the Truveta EHR dataset, is crucial for continuously monitoring prescription trends, identifying emerging patterns, and informing decision-making processes.
Access and Insurance Coverage: The high cost of GLP-1 RA medications and potential limitations in insurance coverage, particularly for patients without a T2D diagnosis, may impact medication initiation and adherence. Addressing these barriers could help ensure equitable access to these therapies.
Medication Shortages: The rapid adoption of these medications, coupled with potential supply chain disruptions, may lead to medication shortages, requiring proactive inventory management and contingency planning by healthcare providers and IT systems.
Effectiveness and Safety Evaluation: As the use of GLP-1 RA medications continues to evolve, ongoing research and real-world evidence are needed to assess their long-term effectiveness, safety, and suitability for use in diverse clinical settings, including military and other austere environments.
Interdisciplinary Collaboration: Addressing the complex challenges surrounding GLP-1 RA prescribing and utilization will require close collaboration between healthcare professionals, IT specialists, policymakers, and researchers to develop comprehensive solutions that prioritize patient outcomes and healthcare system efficiency.

By staying informed about the latest trends and insights in GLP-1 RA prescribing, the IT and healthcare communities can work together to enhance the delivery of effective, accessible, and sustainable obesity and diabetes management solutions. The Truveta Research team’s ongoing monitoring and reporting efforts will continue to provide valuable data-driven intelligence to support these important endeavors.

To access the full GLP-1 RA monitoring report, including detailed methodology, additional findings, and citations, please visit the Truveta Studio or the medRxiv preprint server. For more information and resources, visit the IT Fix blog.