GLP-1 medication access limited by care site, payer type, demographics
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Key takeaways:
- Female sex, older age and high-deductible or preferred plans were tied to GLP-1 initiation.
- Exclusive provider, health maintenance plans and an inpatient obesity diagnosis were tied to lower GLP-1 initiation.
SAN ANTONIO — Access to GLP-1 medications is potentially impacted by care site, payer type and demographics, highlighting gaps in care that disproportionately affect certain patient subgroups, according to a presentation at ObesityWeek.
“We know that individuals that have obesity, but not diabetes, are a unique subpopulation in the context of metabolic health, because they may be undertreated relative to individuals that also have diabetes, but they are still at elevated risk of cardiometabolic consequences and developing diabetes,” Meghan Podolsky, MS, graduate research assistant at Boston University School of Public Health, said during a presentation.
Podolsky and colleagues identified 111,045 adults diagnosed with obesity between June 2021 and July 2022 with at least 2 years of continuous enrollment in MarketScan data. All individuals sought inpatient or outpatient obesity care after 6 months and were followed for 18 months. Researchers identified the top 20 most important variables for GLP-1 receptor agonist initiation among this dataset.
Overall, 2.5% of the cohort received an initial GLP-1 receptor agonist prescription within 6 months of diagnosis.
Patients with a higher likelihood of initiating GLP-1 medications included:
- women;
- antidepressant users;
- full-time employees;
- service industry employees; and
- individuals aged 45 to 54 years.
Within 6 months, GLP-1 medication initiation was more likely with use of the following medications before initial obesity diagnosis:
- adrenal medications;
- anticonvulsants;
- benzodiazepine;
- thyroid medications;
- antidepressants; and
- amphetamines.
Conversely, individuals with exclusive provider organization or HMO insurance types were least likely to initiate GLP-1 medications within 6 months.
“Some additional things that we’re looking at doing are incorporating place of service and type of provider at obesity diagnosis, incorporating social determinants of health, including linking geographic comparables, such as social vulnerability index extended to Medicaid and Medicare populations as well as including measured BMI and lab data,” Podolsky said.
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Podolsky M, et al. Oral-028. Presented at: ObesityWeek; Nov. 3-6, 2024; San Antonio.
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