Prescribing GLPs for Obesity Treatment for Adults at a University Based Health Maintenance Organization by Race, Ethnicity, and Socioeconomic Status.

BACKGROUND

While glucagon-like peptide-1 receptor agonists and dual glucagon-like peptide-1 receptor/GIP agonists (GLPs) have revolutionized the treatment of obesity, national data shows Black patients, Hispanic patients, and patients of lower socioeconomic status are less likely to receive anti-obesity medications.

OBJECTIVE

To assess the association between Black race, Hispanic ethnicity, and low socioeconomic status on GLP prescription receipt for adults in a university-based staff model health maintenance organization (HMO).

DESIGN

Cross-sectional study using electronic health record data.

PARTICIPANTS

Adults (≥ 18 years) enrolled in Yale Health with a body mass index (BMI) ≥ 27 kg/m2 with at least one obesity-related condition or BMI ≥ 30 kg/m without diabetes.

MAIN MEASURES

The main outcome measure was receipt of a GLP prescription for obesity treatment, including subcutaneous liraglutide, semaglutide, or tirzepatide. Main independent variables of interest included self-reported race (Asian, Black, White, Other, and Missing), ethnicity (Hispanic, non-Hispanic), and area deprivation index (ADI) quintile. Three logistic regression models examined the association of race, ethnicity, and socioeconomic status on prescription receipt: 1) an unadjusted model, 2) an adjusted model for age, sex, and clinical characteristics, and 3) an adjusted model with socioeconomic status.

KEY RESULTS

Among 6,225 eligible patients, 1,143 (18.3%) were prescribed a GLP. Black patients (21.5%) and Hispanic (23.1%) patients had higher prevalence of prescriptions compared to White patients (17.5%; p < 0.001) and non-Hispanic patients (18.1%; p < 0.001). In adjusted models, Black patients (OR = 0.94 [0.78-1.13]) and lowest ADI quintile patients (OR = 0.87 [0.65-1.16]) did not have statistically different odds of receiving a GLP prescription compared to White patients and the highest ADI quintile patients. Hispanic patients had slightly increased adjusted odds of prescription receipt compared to non-Hispanic patients (OR = 1.27 [1.00-1.63]).

CONCLUSIONS

In a university-based staff model HMO, there were no disparities in receipt of GLP prescriptions for obesity across racial, ethnic, or socioeconomic groups.