(160) Trends in Characteristics and Anti-Obesity Medication Use Among US Employees in the Era of Glucagon-like Peptide-1 Receptor Agonists (GLP-1 RAs)

Background: : Obesity rates in the United States (US) are substantial and increasing over time. The Centers for Disease Control (CDC) reports a 40% US prevalence of obesity between 2021 and 2023. Obesity is associated with many comorbid conditions, accounting for ~16.5% of all health expenditures, and poses a significant burden on the US healthcare system. The introduction of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) may have affected trends in use and costs associated with obesity therapy.

Objective: : To understand trends in obesity diagnoses (Dx), comorbid conditions, pharmacotherapy (including GLPI-RA medications) and related costs among US working age employees.

Methods: : Retrospective analysis of Workpartners Research Reference Database (RRDb) of US employees from all 50 states from 2001 to present. Employee patients were identified as obese if they had medical claims with ICD-10 codes for obesity (E66) between 2016 and 2022. Patients were also included if they had a prescription claim for a drug indicated only for treatment of obesity (orlistat, phentermine, phentermine-topiramate, naltrexone-bupropion, or a weight loss approved GLP-1 RA) with first prescription date as the index date for obesity diagnosis. Trends in comorbidities, medical, total prescription, and obesity-prescription costs were examined based on paid claims. Absence and short-term disability days were examined based on employer human resource data. Costs inflation adjusted to December 2023.

Results: : From 2016—23, there were 127,408 employees with an obesity diagnosis, prevalence increased from 11.5% in 2020 to 16.9% in 2023 with mean age 44.6 years and 56.7% female. Study employees had low Charlson Comorbidity Index scores, mean 0.51 (range 0.46—0.58). Rates of comorbid conditions remained stable over time for T2DM (11.3%—16.1%), cardiovascular disease (4.4 to 5.3%), chronic kidney disease (1.4% to 1.7%), sleep apnea (12.4% to 14.7%) and NASH (0.25% to 0.43%). Patients had a mean of 5.9 drug classes prescribed each year, with $2,687 mean total prescription costs (range $2,198—$3,862). The uptake of GLP1-RAs among employees with obesity increased yearly, (3.6% in 2016—18.3% in 2023) and contributing substantially to annual drug costs (~30% by 2023). However, medical costs and work-related costs remained stable with time. Overall GLP1-RA persistence was 78% in the year following the index year.

Conclusions: : The uptake of GLP1-RAs for obesity has increased substantially since their initial approval but their impact on medical and work-related costs are yet to be realized.

Sponsorship:: None