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Study: SGLT2 inhibitor prescriptions outpace antiobesity prescriptions 15 to 1
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Clinicians are 15 times more likely to prescribe an SGLT2 inhibitor to a patient with obesity and type 2 diabetes than an antiobesity therapy, according to study findings published in Obesity.
“Given the close tie between obesity and type 2 diabetes, treating obesity should be an obvious first step for health care providers to prevent and treat diabetes,” Catherine E. Thomas, MS, of Weill Medical College of Cornell University, said in a press release. “By treating obesity, we may be able to decrease the number of patients with type 2 diabetes, among other related diseases and the medications used to treat them.”
In a retrospective study, Thomas and colleagues analyzed 2012-2015 data from the IMS Health National Prescription Audit, a database of all dispensed prescription information from 38,939 U.S. pharmacies (retail, long-term care and mail service), which represents 70% of the dispensed outpatient prescription volume in the U.S., as well as the Xponent database, which contains demographic and dispensed prescription information for U.S. prescribers.
Using linear regression analysis, researchers assessed the adoption rate of antiobesity pharmacotherapies and SGLT2 inhibitors, evaluating the change in mean prescriptions per month over the analysis period. Three separate univariate linear regressions were performed to model prescriptions dispensed over time for new antiobesity pharmacotherapies, SGLT2 inhibitors and phentermine, respectively. Researchers stratified prescriptions by monthly intervals for each pharmacotherapy group, starting from the month of inception for the new pharmacotherapy groups, until August 2015.
Excluding insulin, as of August 2015, the number of dispensed antidiabetes prescriptions was 15 times the number of dispensed antiobesity medications; SGLT2 inhibitors comprised 4.9% of the antidiabetes pharmacotherapy market share, which was equivalent to three-quarters of all dispensed antiobesity prescriptions, according to researchers.
Over the study period, the mean increases in prescriptions per month were 25,259 for SGLT2 inhibitors (95% CI, 23,133-27,383); 5,154 for new antiobesity medications (95% CI, 4,800-5,507) and 2,718 for phentermine (95% CI, 1,345-4,089). As of August 2015, for each new prescription dispensed, there were 5.4 continuing prescriptions dispensed for phentermine, 4.6 for SGLT2 inhibitors, and 1.4 for new antiobesity pharmacotherapies, according to researchers.
Prescribers of antiobesity medications included general practitioners, internal medicine clinicians and endocrinologists.
“The adoption rate of [SGLT2 inhibitors] was nearly exponential, while the adoption rate of new antiobesity pharmacotherapies was linear,” the researchers wrote. “The disparity in dispensed prescription volumes and in the ratio of new prescriptions to continuing prescriptions between antiobesity pharmacotherapies and [SGLT2 inhibitors] indicate that there are barriers to antiobesity pharmacotherapy initiation and long-term adherence. This is likely the result of multiple factors stemming from the delayed recognition of obesity as a disease by leading public health and medical organizations.”
The researchers pointed to a number of barriers to obesity treatment, including lack of reimbursement for health care providers, limited time during office visits, lack of training in counseling, and competing demands, among others. –by Regina Schaffer
Disclosure: The study was conducted through a partnership with Vivus, Inc.
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