Gleason Patrick P, Urick Benjamin Y, Marshall Landon Z, Friedlander Nicholas, Qiu Yang, Leslie R Scott
Prime Therapeutics, LLC, Eagan, MN.
J Manag Care Spec Pharm. 2024 Aug;30(8):860-867. doi: 10.18553/jmcp.2024.23332. Epub 2024 May 8.
In 2014, the US Food and Drug Administration approved the first glucagon-like peptide-1 (GLP-1) receptor agonist product, liraglutide injection, for obesity treatment. Many GLP-1 obesity treatment clinical trials report significant weight loss and medication adherence at more than 85%. Little is known about the real-world GLP-1 obesity treatment adherence, persistence, and switch rates.
To measure GLP-1 therapy persistence, adherence, and switch rates in a real-world cohort of members without diabetes using these drugs for obesity treatment.
Integrated pharmacy and medical claims data from 16.5 million average monthly commercially insured membership were used to identify obese members without diabetes newly initiating GLP-1 therapy between January 1, 2021, and December 31, 2021. Members were required to be continuously enrolled 1-year before and after the GLP-1 therapy start date and aged 19 years of age or older. Persistence was measured as no greater than or equal to 60-day gap with allowance for GLP-1 switching. Adherence was measured as the proportion of days covered (PDC) and members with a PDC greater than or equal to 80% were considered adherent. GLP-1 product switching was also assessed descriptively.
4,066 commercially insured obese members without diabetes that newly initiated GLP-1 therapy met all study criteria. The mean age was 46 years, and 81% were female. Overall, GLP-1 persistence was 46.3% at 180 days and 32.3% at 1 year. The highest and lowest persistence rates at 1 year were observed for semaglutide (Ozempic) at 47.1% and liraglutide (Saxenda) 19.2%, respectively. Average PDC during the 1-year assessment was 51.0% with 27.2% adherent to therapy and 11.1% switched GLP-1 drugs.
This GLP-1 weight loss treatment real-world analysis, among obese individuals without diabetes, found poor 1-year persistence and adherence and low rates of switching between products. These findings will aid in assessing products cost-effectiveness, understanding obesity care management program needs, forecasting future GLP-1 use and cost trends, and negotiating GLP-1 pharmaceutical manufacturer value-based purchasing agreements.
2014年，美国食品药品监督管理局批准了首个用于肥胖治疗的胰高血糖素样肽-1（GLP-1）受体激动剂产品——利拉鲁肽注射液。许多GLP-1肥胖治疗临床试验报告称，体重显著减轻，药物依从性超过85%。关于现实世界中GLP-1肥胖治疗的依从性、持续性和换药率，人们了解甚少。
在一个使用这些药物治疗肥胖的无糖尿病成员的现实队列中，衡量GLP-1治疗的持续性、依从性和换药率。
利用来自1650万平均每月有商业保险的成员的综合药房和医疗理赔数据，识别在2021年1月1日至2021年12月31日期间新开始GLP-1治疗的无糖尿病肥胖成员。成员在GLP-1治疗开始日期前后需连续参保1年，年龄在19岁及以上。持续性的衡量标准是与GLP-1换药间隔不超过60天。依从性通过覆盖天数比例（PDC）来衡量，PDC大于或等于80%的成员被视为依从。还对GLP-1产品换药情况进行了描述性评估。
4066名新开始GLP-1治疗的有商业保险的无糖尿病肥胖成员符合所有研究标准。平均年龄为46岁，81%为女性。总体而言，GLP-1治疗180天时的持续性为46.3%，1年时为32.3%。1年时，司美格鲁肽（Ozempic）的持续性最高，为47.1%，利拉鲁肽（Saxenda）的持续性最低，为19.2%。1年评估期间的平均PDC为51.0%，27.2%的成员坚持治疗，11.1%的成员更换了GLP-1药物。
这项针对无糖尿病肥胖个体的GLP-1减肥治疗的现实世界分析发现，1年的持续性和依从性较差，产品间换药率较低。这些发现将有助于评估产品的成本效益、了解肥胖护理管理项目的需求、预测未来GLP-1的使用和成本趋势，以及协商GLP-1制药商基于价值的采购协议。
