(156) Three-Year Real-World Adherence and Persistence to Glucagon-Like Peptide-1 Receptor Agonists among Commercially Insured Adults with Obesity without Diabetes

Background: : Real-world evidence has found most patients without diabetes newly initiating GLP-1 drug therapy for weight loss discontinue within the first two years. Little is known of the long-term GLP-1 obesity treatment adherence and persistency.

Objective: : To measure adherence and persistence to obesity GLP-1 therapy at the end of 3 years follow up in a real-world cohort of non-diabetic commercially insured members.

Methods: : Prime Therapeutics’ integrated pharmacy and medical claims data from an average of 16.5 million commercially insured lives were used to identify members without diabetes newly initiating GLP-1 obesity treatment between 1/1/2021 and 3/31/2022 (index date period). GLP-1 new initiation was defined as no GLP-1 claim in the 365 days prior to the member’s first GLP-1 found in the index period (pre-period). Study inclusion was limited to members with continuous enrollment, meaning no more than a total of 15 days without enrollment in the pre-period and each year in the three-year post-period, and no GLP-1 drug claim in the pre-period. During the pre-period, members were required to have a medical claim indicating obesity without a diabetes diagnosis or diabetes drug claim, and aged 19 years or older. Adherence was measured as the proportion of days covered (PDC) in the post-period and members with a PDC ≥80% considered adherent. Persistence was measured as no ≥60-day gap between a claim days’ supply ending and a subsequent claim fill date in the post period. GLP-1 product switching was allowed during the assessment period and switch rates were descriptively assessed.

Results: : Among the 10,292 obese members without diabetes with a GLP-1 claim during the index date period, 5,781 (56.2%) were continuously enrolled in the 3-year post-period. The mean age was 46.7 years and 79.9% were female. Overall GLP-1 persistency was 8.1% at 3 years. The highest and lowest persistency rates at three years were observed for weekly semaglutide (14.3%; Wegovy) and daily liraglutide (2.5%; Victoza), respectively. Average GLP-1 PDC over 3 years was 37.5%, with 12.5% of members adherent and 32.9% switched GLP-1 drugs.

Conclusions: : Three-year GLP-1 weight-loss treatment persistence was poor, with 1 in 12 members remaining on therapy. These findings highlight GLP-1 therapy investment risk due to poor persistence leading to unachieved clinical benefits for members who initiated in 2021 and early 2022. Obesity care management programs and value-based contracts from pharmaceutical manufacturers may help mitigate financial risk.

Sponsorship:: Prime Therapeutics, LLC