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Trends in glucagon-like peptide 1 receptor agonist prescribing patterns
Maria Ukhanova1, Joseph S Wozny, Chau N Truong
1UTHealth Houston School of Public Health, Center for Health Care Data, 1200 Pressler St, Houston, TX 77030.
The American Journal of Managed Care
|August 19, 2025
Summary
Glucagon-like peptide 1 receptor agonists (GLP-1 RAs) prescribing increased significantly, especially semaglutide for weight loss in non-diabetic patients. This trend highlights evolving treatment patterns for obesity and related conditions.
Area of Science:
- Endocrinology
- Pharmacology
- Public Health
Background:
- Obesity affects over 40% of US adults, increasing risks for cardiovascular disease and type 2 diabetes.
- Glucagon-like peptide 1 receptor agonists (GLP-1 RAs) show promise for weight loss but face challenges like cost and prescribing practices.
- Research is needed on GLP-1 RA prescribing patterns, particularly in patients without diabetes.
Purpose of the Study:
- To analyze trends in GLP-1 RA prescribing from 2018 to 2023.
- To compare semaglutide with other GLP-1 RAs.
- To assess prescribing patterns in patients with and without diabetes, focusing on potential premature prescribing for weight management.
Main Methods:
- Retrospective, population-based, observational study using Merative MarketScan databases (2018-2023).
- Analysis of GLP-1 RA prescribing rates, stratified by diabetes and overweight/obesity indications.
- Inclusion criteria: individuals aged 18+ with 12 months continuous enrollment.
Main Results:
- GLP-1 RA prescriptions, particularly semaglutides, increased notably from 2018-2023, while other GLP-1 RAs declined.
- In non-diabetic users, a slight increase in prediabetes or abnormal glucose diagnoses was observed before GLP-1 RA initiation.
- Less than 9% of non-diabetic users received a diabetes or prediabetes diagnosis within 30 days of starting a GLP-1 RA.
Conclusions:
- GLP-1 RA prescribing significantly increased between 2018 and 2023.
- Semaglutide captured 60% share in the non-diabetic obese/overweight group, reflecting its approval for weight loss.
- Significant rise in GLP-1 RA prescriptions for non-diabetic and obese/overweight patients observed.
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