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Real-time monitoring of GLP-1 RA medications: Prescription trends from January 2018 through December 2023

by | Jan 23, 2024 | Research

  • Overall prescribing rates (GLP-1 RA prescriptions per total prescriptions) have remained stable in the last 3 months, with rates in December 2023 about the same as rates in November 2023 and October 2023.
  • For the anti-diabetic medications (ADMs), the number of patients prescribed an ADM in December 2023 remained about the same as the number in both November 2023 and October 2023. Among ADMs, semaglutide was the most prescribed medication. In late 2023, tirzepatide surpassed dulaglutide as the second most commonly prescribed ADM.
  • For the anti-obesity medications (AOMs), the number of patients being prescribed an AOM continues to increase. The number of patients prescribed an AOM in December 2023 was 1.2 times November 2023 and 1.1 times October 2023. Among AOMs, semaglutide (Wegovy) was the most prescribed medication, followed by AOM liraglutide (Saxenda). Prescribing of AOM tirzepatide (Zepbound) was observed in the first month of availability in pharmacies, December 2023.

Limited recent data exist on prescribing patterns and patient characteristics for GLP-1 RA medications, whether used as anti-diabetic medication (ADM) for patients with type 2 diabetes and/or used as an anti-obesity medication (AOM) for patients with overweight or obesity. Interest in these medications has recently accelerated, largely for their weight-loss effects, although access to and use of GLP-1 RA medications may be impacted by high cost, limited insurance coverage for patients without T2D and medication shortages.

To offer insight into the latest data about these medications, Truveta Research has created the GLP-1 RA monitoring report, which will be updated periodically with fresh, timely data. Because Truveta Data provides the most complete, timely, and clean de-identified EHR data, including full patient medical records, notes, and images, linked with claims, SDOH, and mortality data for more than 100 million patients across the US, we can show the latest trends in these medications, including the early uptake in tirzepatide labeled for obesity (Zepbound), which was approved by the FDA in November 2023.

This blog provides a snapshot of the key findings in the report specific to prescribing trends. For the full analysis – inclusive of demographics, comorbidities, and social drivers of health data for the population, methodology, findings (including dispensing trends, which indicates whether the patient picked up the medication and can be a proxy for understanding medication adherence), limitations, and citations – you can view the complete report on MedRxiv. You can also view the full report in Truveta Studio — including methodology, definitions, and full population.

Key findings: Prescribing trends

Using a subset of real-world electronic health record (EHR) data from Truveta, we identified people who were prescribed a GLP-1 RA between January 01, 2018 and December 31, 2023. We describe prescribing volumes and patient characteristics over time, by medication, and by FDA-labeled use (e.g., use as anti-diabetic medication (ADM), an anti-obesity medication (AOM), or unknown).

Overall prescribing trends
  • The report found that 1,063,200 patients were prescribed a GLP-1 medication between January 2018 and December 2023, with 4,213,888 total prescriptions during this period.
  • Overall prescribing rates (GLP-1 RA prescriptions per total prescriptions) have remained stable in the last 3 months; rates in December 2023 are about the same as rates in November 2023 and October 2023.
  • Among first-time prescriptions for which use could be established, ADMs accounted for 86.6% and AOMs accounted for 13.4%.
  • For the anti-diabetic medications (ADMs):
    • The number of patients prescribed an ADM in December 2023 remained about the same as the number in both November 2023 and October 2023.
    • Among ADMs, semaglutide (Ozempic) was the most prescribed medication. In late 2023, tirzepatide (Mounjaro) surpassed dulaglutide (Trulicity) as the second most commonly prescribed ADM.
  • For the anti-obesity medications (AOMs):
    • The number of patients being prescribed an AOM continues to increase. The number of patients prescribed an AOM in December 2023 was 1.2 times November 2023 and 1.1 times October 2023.
    • Among AOMs, semaglutide (Wegovy) was the most prescribed medication, followed by AOM liraglutide (Saxenda).
    • Prescribing of AOM tirzepatide (Zepbound) was observed in the first month of availability in pharmacies, December 2023.
Rate of GLP-1 RA medication prescriptions over time including Ozempic, Wegovy, Mounjaro, Zepbound, Trulicity and others
Cumulative rate of GLP-1 RA medication prescriptions over time including Ozempic, Wegovy, Mounjaro, Zepbound, Trulicity and others
Changes in rate of GLP-1 RA medication prescriptions over time including Ozempic, Wegovy, Mounjaro, Zepbound, Trulicity and others
Trends in first-time prescribing and dispensing
  • First-time prescribing rates (first-time GLP-1 RA prescriptions per total prescriptions) in December 2023 were slightly lower than rates in November 2023 and October 2023.
  • Patients first-prescribed ADMs filled their GLP-1 RA medications at a higher rate: 71.5% of those prescribed an ADM compared to 45.6% prescribed an AOM filled a GLP-1 RA prescription within 60 days of the first prescription.
  • Trends for first-time prescribing of anti-diabetic medications (ADMs):
    • First-time prescribing of ADMs was lower in the most recent month, with first-time prescribing rates in December 2023 being 0.8 times that of November 2023.
    • Similar to overall prescribing, semaglutide was the most commonly first-prescribed ADM overall and in the most recent period.
  • Trends for first-time prescribing of anti-obesity medications (AOMs):
    • First-time prescribing of AOMs was similar in the most recent month, with first-time prescribing rates in December 2023 being about the same as November 2023.
    • While overall prescribing of semaglutide increased throughout 2023, first-time prescribing of semaglutide slowed after the first quarter of 2023 from 0.9% of all prescriptions in May 2023 to 0.5% in December 2023. Similar declines were observed for ADM, AOM, and unknown semaglutide.
    • First-time prescribing of tirzepatide increased throughout 2023, and we see evidence of the first prescribing of AOM tirzepatide (Zepbound) in December 2023.
Rate of first-time GLP-1 RA medication prescriptions over time including Ozempic, Wegovy, Mounjaro, Zepbound, Trulicity and others
Cumulative rate of first-time GLP-1 RA medication prescriptions over time including Ozempic, Wegovy, Mounjaro, Zepbound, Trulicity and others
Changes in rate of first-time GLP-1 RA medication prescriptions over time including Ozempic, Wegovy, Mounjaro, Zepbound, Trulicity and others

Discussion

With the popularity of GLP-1 RA medications, challenges in access, and the availability of new medications like AOM tirzepatide (Zepbound), we will continue to monitor these prescribing and dispensing trends over time.

The GLP-1 RA monitoring report describes more detailed information about the overall population of patients being prescribed these medications (including demographics, comorbidities, social drivers of health data like income and education, and more), and the proportion and characteristics of patients who actually filled a GLP-1 RA prescription over time using dispenses. Methodologies, limitations, and additional citations are also available in the full report.

These are preliminary research findings and not peer reviewed. All data are preliminary and may change as additional data are obtained. These findings are consistent with data accessed January 15, 2024. Data presented in this analysis represent raw counts and/or rates, and post-stratification methods have not been conducted.