GLP-1 receptor agonist prescriptions for obesity have risen in those without diabetes

Key takeaways:

• Semaglutide was the highest newly prescribed GLP-1 receptor agonist in 2023.
• The proportion of new users without FDA-approved indications rose from 0.21% to 0.37% from 2019 to 2023.

New prescriptions of GLP-1 receptor agonists for the treatment of obesity have increased significantly among individuals without type 2 diabetes in the last decade, according to a study in Annals of Internal Medicine.

The recent rise in GLP-1 receptor agonist prescriptions “has resulted in a medication shortage,” according to Yee Hui Yeo, MD, MSc, from Cedars-Sinai Medical Center, and colleagues.

“However, there are limited data on the trend of prescription patterns of GLP-1 receptor agonists based on indications,” they wrote.

Researchers analyzed the records of about 45 million people with at least one inpatient or outpatient visit between 2011 and 2023 to determine trends in new GLP-1 receptor agonist prescribing.

They found 1 million new GLP-1 receptor agonist users during the analysis’ time period, including mostly women, non-Hispanic white individuals and those with a BMI of 30 kg/m² or greater.

The proportion of new GLP-1 receptor agonist users with type 2 diabetes decreased during the study period in tandem with a twofold increase in the proportion of new users without type 2 diabetes and a BMI of 30 kg/m² or greater or a BMI between 27 kg/m² and 30 kg/m² and an obesity-related comorbid condition.

Yeo and colleagues also reported an increase in the proportion of new users without FDA-approved indications, which rose from 0.21% to 0.37% between 2019 and 2023.

Semaglutide (Wegovy/Ozempic, Novo Nordisk) and liraglutide (Saxenda, Novo Nordisk) made up 31.4% and 35.3% of all new GLP-1 receptor agonist prescriptions in 2019, respectively.

In 2023, semaglutide made up 88.1% of new prescriptions in 2023, whereas liraglutide made up just 10.3%.

Researchers noted multiple study limitations, including use of records

from health care organizations within the federated health research network TriNetX that “may not be nationally representative,” they wrote.

Missing BMI data could affect interpretation of the results, they added.

Yeo and colleagues explained that with rising obesity in the U.S., the increasing prevalence of GLP-1 receptor agonists prescribed for obesity “may contribute to drug shortages.”

“Further, drug shortages may exacerbate the existing nationwide racial and ethnic disparities in GLP-1 receptor agonist prescriptions,” they wrote, adding that the results suggest a “call for strategies to address the growing demand and ensure equitable access” to the drugs.