Changes in Semaglutide Fills Following Expanded FDA and Medicare Policies

The glucagon-like peptide-1 receptor agonist (GLP-1 RA) semaglutide has several branded versions, including Wegovy, which was initially approved for chronic weight management. In March 2024, the FDA expanded Wegovy's indications to include reducing cardiovascular events in patients with overweight or obesity and cardiovascular disease. That same month, Medicare Part D expanded coverage for this indication. Evidence is lacking on how these policy changes have affected the utilization of Wegovy and other semaglutide products.

Retrospective analysis of monthly semaglutide fills in the US before and after expanded FDA indications and Medicare coverage.

IQVIA National Prescription Audit PayerTrak data were used to assess temporal trends in semaglutide utilization by brand and payer between September 2023 and September 2024. Additionally, linear segmented regression was used to identify the number of additional fills associated with the FDA and Medicare policy changes.

Total semaglutide utilization increased during the study period, with Wegovy showing the largest relative increase compared with the prepolicy period (136.4%) among all semaglutide products. The greatest increase in relative utilization by payer was for Wegovy purchased through Medicare Part D (598.1%). Policy implementation was associated with an estimated 592,624 additional Wegovy fills by September 2024.

Expanded FDA indications and Medicare coverage of semaglutide for cardiovascular risk prevention were associated with increased Wegovy utilization, most notably through Medicare Part D. These policies may serve as a template for improving access to semaglutide and other GLP-1 RAs as the clinical indications for these drugs continue to expand.