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Factors Associated With Semaglutide Initiation Among Adults With Obesity
Meghan I Podolsky1,2, Rafeya Raquib1, Paul R Shafer3
1Department of Global Health, School of Public Health, Boston University, Boston, Massachusetts.
JAMA Network Open
|January 21, 2025
Summary
Semaglutide uptake for weight management in individuals without diabetes is linked to sociodemographic factors and insurance plan type. These factors highlight potential intervention points for equitable access to obesity treatments.
Area of Science:
- Pharmacological interventions for obesity management.
- Health services research and healthcare disparities.
- Real-world evidence in metabolic disease treatment.
Background:
- Semaglutide, a GLP-1 receptor agonist, is approved for weight management in obesity.
- Limited data exists on semaglutide uptake in non-diabetic obese populations.
- Understanding initiation factors is crucial for equitable access.
Purpose of the Study:
- To identify factors associated with semaglutide initiation in commercially insured adults with obesity but no diabetes.
- To explore sociodemographic, clinical, and healthcare access predictors of semaglutide use.
Main Methods:
- Retrospective observational cohort study using Merative MarketScan data (2021-2022).
- Included adults with obesity, no prior anti-obesity medication, GLP-1, bariatric surgery, or diabetes claims.
- Random forest and logistic regression models analyzed factors associated with semaglutide initiation within 6 months of obesity diagnosis.
Main Results:
- 2.0% of 97,456 participants initiated semaglutide.
- Key predictors included female sex (aOR 2.30), antidepressant use (aOR 1.62), and point-of-service insurance plans (aOR 1.78).
- Model achieved an AUC of 0.71, indicating moderate predictive performance.
Conclusions:
- Sociodemographic, clinical, and insurance factors influence semaglutide receipt in non-diabetic obese individuals.
- Insurance plan type is a significant factor, suggesting it as an intervention point for equitable obesity treatment access.
- Further research can optimize access to novel weight management therapies.
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