Initiators of Semaglutide in General Practice in New South Wales, 2020-2023: A Retrospective Cohort Study

We aimed to analyse trends and demographic and clinical profiles in initial prescriptions of semaglutide ("Ozempic") by general practitioners in New South Wales between 2020 and 2023.

This retrospective cohort study used electronic medical records from the New South Wales Health Lumos program, covering 680 general practices from January 2020 to November 2023. Individuals aged ≥18 years with a first general practice prescription for semaglutide ("initiators") were included. Counts and proportions of semaglutide initiators by year, sex, age, socioeconomic status, body mass index, and type 2 diabetes mellitus (T2DM) status were compared over time.

Between 2020 and 2023, 59,009 individuals had a first general practice prescription for semaglutide, increasing from 448 in 2020 to 36,814 in 2023. Women comprised 63.6% of total initiators. The proportion of initiators with T2DM decreased from 92.2% in 2020 to 65.9% in 2023. Initiators with T2DM had a higher median age (women 53 years, men 59 years) compared to non-T2DM initiators (45 years for both sexes) and were more likely to live in socioeconomically disadvantaged areas. Greater proportions of non-T2DM initiators were aged <40 years, were female, and resided in less disadvantaged areas. Non-T2DM female initiators were less likely to be obese than those with T2DM (75.7% vs 79.3%), but the converse was true for men (91.0% vs 77.3%). Almost 30% of male initiators and 20% of female initiators without T2DM had a body mass index of >40 kg/m².

The use of semaglutide in Australia is expanding rapidly, particularly among individuals without T2DM. Patterns in general practice prescribing of semaglutide differ by sex, T2DM status, and socioeconomic factors, raising important questions about equitable access. These trends underscore the need for coordinated policy responses to support fair and sustainable use as demand continues to grow.