Semaglutide prescribing patterns suggest there was a steady increase in utilization despite shortages during the first year of launch, according to findings presented at AMCP 2023.

Semaglutide is an injectable weight loss medication approved in June 2021. Each pen delivers a specific dose for titration and maintenance: 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, and 2.4 mg. The 0.25-mg and 0.5-mg doses were subject to supply issues in late 2021 and were temporarily taken off the market to minimize demand. Supply issues also affected the 1-mg dose in May 2022.

Researchers evaluated “the impact of semaglutide supply issues on titration schedule, maintenance dosing and switching patterns among glucagon-like peptide-1 receptor agonist (GLP-1 RA) products.” 

Pharmacy claims data was used to source 2381 commercially insured members for the retrospective cohort study. Members needed to be continuously enrolled in Blue Cross Blue Shield of Michigan (BCBSM), with pharmacy and medical benefits, from June 1, 2021, to June 30, 2022. They also had to have at least 1 pharmacy claim for injectable semaglutide for weight loss (sema-wt), injectable semaglutide for diabetes (sema-dm), or liraglutide (lira-wt) during the study period. 

Index claim was defined as the first GLP-1 RA claim during the study period. Members were grouped by drug switch pattern, and researchers studied each group’s switching behavior based on the number of unique members by month and a comparison of pre- and postswitch strengths.

Despite supply issues, there was an increase in the number of unique members receiving sema-wt (n = 647) within 6 months of launch. This number peaked in March 2022 (n = 1491), representing an increase of 130.4%, and began declining in April 2022 (n = 1428). Sema-wt prescriptions were filled by 1160 members at 12 months postlaunch. 

Findings show 28% of members switched drugs during the study from: 

• lira-wt to sema-wt (n = 243; 36.4%);
• sema-dm to sema-wt (n = 123; 18.4%);
• sema-wt to lira-wt (n = 121; 18.1%);
• sema-wt to sema-dm (n = 90; 13.5%); and
• and multiple switch (n = 90; 13.5%). 

Switches from lira-wt or sema-dm to sema-wt were most frequent from September 2021 to December 2021, after which the rate of switching plateaued. Switches from sema-wt to sema-dm or lira-wt were minimal at first, but switches increased substantially from March 2022 to June 2022, according to the findings.
Semaglutide utilization steadily increased despite first-year launch supply shortages, researchers concluded.

“Drug switches among other GLP-1 RA appeared to coincide with key events in the shortage, possibly to minimize care disruption,” explained researchers. 

Reference:
Mo M, Stievater T, Tungol A,. Impact of semaglutide strength supply shortages on real-world prescribing patterns. J Manag Care Spec Pharm. 2023;29(10-a suppl):S1-S137. https://www.jmcp.org/pb-assets/Poster%20Abstract%20Supplements/AMCP2023_PosterAbstractSupplement_0317-1679318682267.pdf