SAT664 Obesity And Overweight Diagnosis, Physician Prescription And Patient Filling Of Anti-Obesity Medications In US
Authors: Ezendu Kyrian , Choong Casey Kar-Chan , Brown Madeline , Malik Raleigh , Hankosky Emily R 
Published: October 2023

Disclosure: K. Ezendu: Employee; Self; Eli Lilly & Company. C.K. Choong: Employee; Self; Eli Lilly & Company. Stock Owner; Self; Eli Lilly & Company. M. Brown: Employee; Self; Eli Lilly & Company. R. Malik: Employee; Self; Eli Lilly & Company. Stock Owner; Self; Eli Lilly & Company. E.R. Hankosky: Employee; Self; Eli Lilly & Company. Stock Owner; Self; Eli Lilly & Company.

Background: The prevalence of obesity and overweight is high and growing in the US adult population. Current trends in diagnosis and treatment with anti-obesity medications (AOMs) of obesity or overweight are unknown. Objectives: To describe obesity and overweight diagnosis rates, AOM prescribing rates, and AOM fill rates in AOM-eligible adults from 2016 to 2021. Methods: Separate cohorts of AOM-eligible adults (18-80 years) were constructed from Optum’s de-identified Market Clarity Data for each year from 2016 to 2021. AOM-eligible individuals were defined as adults with obesity (≥1 body mass index (BMI) value ≥30 kg/m2) or adults with overweight (≥1 BMI 27 - &lt;30 kg/m2) and ≥1 obesity-related complication (ORC) including type 2 diabetes, hypertension, obstructive sleep apnea, dyslipidemia, and cardiovascular diseases. Obesity or overweight diagnosis rates in each cohort (2016-2021) were determined as the percentage of adults with obesity or overweight (as determined by BMI in the electronic health record (EHR)), respectively, who had a corresponding ICD-10 diagnosis in claims or EHR. The prescribing or fill rate of AOMs (i.e., phentermine-topiramate, lorcaserin, orlistat, naltrexone-bupropion, liraglutide, and semaglutide) was determined as the percentage of AOM-eligible members with a written prescription of an AOM in the EHR or at least one filled AOM prescription based on pharmacy claims in each year, respectively. Results: There were between 1,606,593 to 2,277,415 AOM-eligible adults constituting each cohort. The cohorts had similar distributions for age, gender, race, BMI, and insurance type. The obesity diagnosis rate increased from 39.4% in 2016 to 57.2% in 2021, with the diagnosis rate in claims only at 33.5% in 2016 and 47.3% in 2021. The overweight diagnosis rate rose from 18.1% in 2016 to 31.2% in 2021, with the claims-based rate at 15.4% in 2016 and 29.2% in 2021. The prescribing rate for AOMs was low, ranging from 0.4% to 0.5% across all years. Similarly, the fill rates for AOMs rose from 0.4% in 2016 to 0.6% in 2021. From 2016 to 2021, the prescribing and fill rates for incretin AOMs (i.e., liraglutide and semaglutide) doubled (from 0.1% to 0.2%) and quadrupled (from 0.1% to 0.4%), respectively. Conclusions: Despite some increases in recent years, obesity and overweight diagnosis rates remain low, suggesting a significant clinical care gap. Even in the most recent year, less than 3 of 5 people with obesity received an official diagnosis and less than half received a claims-based diagnosis. The overall obesity and overweight diagnoses were higher than reported in claims, signaling a gap in reimbursement. AOM prescribing and filling remained consistently low, with less than 7 in 1000 AOM-eligible adults receiving or filling AOM prescriptions. The clinical care gap for overweight and obesity is substantial, needing effective measures to reduce barriers for obesity care.

Presentation: Saturday, June 17, 2023