A recent study published within the Journal of the American Pharmacists Association examined the trends in usage of glucagon-like peptide (GLP)-1 receptor agonists.

Annual obesity- and overweight-related medical costs in the USA are estimated at $92 billion. Minoritized groups are disproportionately affected by obesity, especially non-Hispanic Black and Hispanic individuals. Recent approvals of several GLP-1 receptor agonists by the Food and Drug Administration (FDA) have drawn interest in cost and demand projections, with discussions on coverage and policy implications.

These discussions will evolve because the evidence of advantages in cardiovascular outcomes emerges from a trial on semaglutide effects in obese/obese individuals. Ozempic and Rybelsus are semaglutides, a category of medicines often called glucagon-like peptide-1 (GLP-1) receptor agonists, approved for type 2 diabetes (T2D). Wegovy is a semaglutide licensed for weight management. Victoza and Saxenda are liraglutides for T2D and weight management, respectively. Trulicity (dulaglutide), Mounjaro (tirzepatide), Byetta (exenatide), and Adlyxin (lixisenatide) are approved for T2D.

Temporary Reports: Trends in Glucagon-like Peptide 1 Receptor Agonist Use, 2014 to 2022. Image Credit: Natalia Varlei / Shutterstock

The study and findings

In the current study, researchers examined the prevalence of GLP-1 receptor agonist use within the US. Patients who were prescribed GLP-1 receptor agonists between 2014 and 2022 were included for evaluation. Electronic health records of patients from 12 hospitals and five academic medical centers were analyzed. Distinct patient counts were determined by brand name.

The monthly exponential growth of Mounjaro, Wegovy, Adlyxin, Rybelsus, Ozempic, Saxenda, and Trulicity in the course of the first 12 months of their availability was estimated using log-linear models. Sub-group analyses were performed by heart problems (CVD), T2D, and obese/obese status before GLP-1 receptor agonist use.

The study included 87,935 patients, aged 59.2, on average. Most subjects were females (55.5%) and White (47.6%). Wegovy and Saxenda users were younger than others and fewer prone to be male. Over 5,000 annual users of Victoza and Trulicity existed between 2014 and 2018. There was a pointy increase in Ozempic users from 569 in 2019 to 13,310 in 2021 and 22,891 in 2022.

There have been 2,992 Wegovy, 2,721 Saxenda, and 1,508 Mounjaro users in 2022. Rybelsus users increased from 1,128 in 2020 to five,937 in 2022. The usage of Adlyxin and Byetta was limited. These trends were similar for obese/obese, T2D, and CVD subgroups. Nevertheless, the rise in Ozempic use was more apparent amongst obese/obese individuals.

Mounjaro and Wegovy showed essentially the most rapid growth during initial availability. Trulicity and Ozempic had comparable growth patterns. Ozempic, Wegovy, Rybelsus, Saxenda, Adlyxin, Trulicity, and Mounjaro reached monthly growth rates of 83.9%, 119.2%, 84.8%, 53.3%, 12.9%, 78.8%, and 254.3%, respectively, of their first 12 months of availability.

Conclusions

Taken together, weight loss-related GLP-1 receptor agonists showed rapid, continuous, and significant increase in usage. The Ozempic count in 2022 was 40 times higher than in 2019. Trulicity, with over 19,000 users in 2022, was second to Ozempic. There have been greater than 30,000 users of semaglutides (Ozempic, Wegovy, and Rybelsus) in 2022.

Trulicity usage slowed after 2021, plausibly as a result of the rapid growth of other GLP-1 receptor agonists related to more significant weight reduction. Rybelsus had a robust growth and was the third most-used agent in 2022. The typical monthly growth rate of Mounjaro, Wegovy, Ozempic, and Rybelsus in the primary 12 months of availability exceeded 85%.

This rapid and immense growth has also caused shortages, with many patients unable to access these medications. Overall, using weight loss-related GLP-1 receptor agonists will proceed to speed up with increasing evidence. Subsequently, informed decision-making is crucial for evidence-concordant prescriptions and provide stability.