Researchers find GLP-1 RA Prescriptions Skyrocketed From 2018 to 2023
A class of medications developed and commonly used to treat diabetes and weight management, glucagon-like peptide 1 receptor agonists (GLP-1 RAs), rose in prescribing trends significantly from 2018 to 2023. This rise is notably due to the prescription of semaglutide (GLP-1 RA) in recent years. Among GLP-1 RA users, only 5% were prescribed semaglutide in 2018, while in 2023 this number rose to 63%. This includes off-label prescribing of Ozempic (semaglutide approved for diabetes) and Wegovy (semaglutide approved for weight loss). While proportion of semaglutide rose during this period, other GLP-1 RAs (dulaglutide, liraglutide, etc) declined, according to a new study published in The American Journal of Managed Care.
The research team, led by first author Maria Ukhanova, MD, PhD, assistant professor in the Department of Management, Policy and Community Health, and the Center for Health Care Data at the School of Public Health, analyzed claims data of over 28 million national members from the Merative™ Marketscan® Research Databases. The research evaluated national trends of various GLP-1 RA medications prescribed between 2018 and 2023 when new GLP-1 RAs such as Ozempic, Wegovy, and Rybelsus received FDA approval.
Over half-a-million individuals who were prescribed one of the GLP-1 RA medications were then categorized into four groups based on diagnoses of diabetes and obesity/overweight identified in claims data:
- Diabetes and no obesity/overweight
- Diabetes and obesity/overweight
- No diagnosis of diabetes nor obesity/overweight
- No diagnosis of diabetes with an obesity/overweight diagnosis
The authors found that GLP-1 RA prescribing patterns varied significantly across diabetics and nondiabetics. Among diabetic patients, Ozempic prescriptions increased 10-fold, while nondiabetic groups experienced a significant increase in Wegovy prescriptions, according to the authors.
In contrast, prescribing patterns between obese/overweight and non-obese/non-overweight groups were relatively similar regardless of a diabetes diagnosis. The proportion of prescribing Saxenda (liraglutide approved for weight management) dropped from 79% in 2018 to 9% in 2023 while in 2023 Wegovy (recieved FDA approval in 2020) was prescribed for 60% of GLP-1 RA users in non-diabetics with obesity/overweight diagnosis. Authors also identified a reduction in off-label prescribing of Ozempic in this group for the first time in 2023. Similar trends highlight the rise of likely off-label semaglutide prescribing and the decline of other forms of GLP-1 RAs were identified in the group without both diabetes and obesity/overweight diagnoses.
“Among GLP-1 RA users without diabetes, approximately 80% were women, whereas diabetic GLP-1 RA users were more evenly split between male and female,” Ukhanova said.
Over the six-year study period, researchers reported a steady increase in obese/overweight diagnoses, which may suggest clinical awareness and the growing use of GLP-1 RA for weight management. “While this study did not directly assess the effect of the popularization of GLP-1 RAs on usage, this study shows how rapidly semaglutide prescribing increased overall and how quickly semaglutide displaced older GLP-1 RAs,” Ukhanova said.
The findings highlight the expanding use of these medications for and beyond diabetes care, raising critical questions for health care coverage, access, premature prescribing from physicians, and high costs.
Additional authors on the study from the Center for Health Care Data included Joseph S. Wozny, MPH; Chau N. Truong, PhD; Lopita Ghosh, MBA; and co-director Trudy M. Krause, DrPH.