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P131: Associations between Social Determinants of Health and Initiation of Wegovy, Ozempic, and Mounjaro

Poster Presenter

Ashwin Anand

Engagement Manager
Forian
United States

Objectives

To conduct a case-control study examining associations between social determinants of health (SDoH; i.e., predictors) and the initiation of three glucose-dependent insulinotropic polypeptide/glucagon-like peptide-1 (GIP/GLP1) receptor agonists: Wegovy, Ozempic, or Mounjaro (i.e., outcomes).

Method

Case patients identified in a US commercial claims real-word data (RWD) source were first treated with a GIP/GLP1 after Jan 1, 2023, and matched (1:4) to control patients with a dispensed prescription in 2023. Logistic regression models described the associations between predictors and outcomes.

Results

This study identified 228,915 patients initiating a GIP/GLP1 (cases) and 915,660 patients treated with other prescription medications (controls) between Jan 1, 2023, and December 31, 2023. All patients had three months of enrollment before the index GIP/GLP1 date or matched treatment date, and all patients had medical and pharmacy commercial claims linked to a consumer data source containing SDoH elements including demographic, socioeconomic, and behavioral characteristics. Cases and controls were 50.7 (SD:8.2) and 45.4 (SD: 13.5) years of age on average and 64.4% and 57.0% female, respectively. Cases were more likely than controls to be Black or Hispanic (11% vs 8% and 13% vs 10%, respectively). A diagnosis of diabetes (ICD-10-CM E10* or E11*) or obesity (ICD-10-CM E66*) was present in 67.7% and 69.2% of cases and 9.1% and 26.8% of controls. Logistic regression models produced odds ratios and 95% confidence intervals examining predictors of GIP/GLP1 initiation, adjusting for demographic and clinical characteristics. Compared to male patients, females were 1.57 (1.41-1.74), 1.63 (1.50-1.77), and 2.62 (2.28-3.00) times more likely to initiate Mounjaro, Ozempic, and Wegovy. Compared to White patients, Hispanic patients were 1.22 (1.04-1.44) and 0.82 (0.67-1.00) times as likely to initiate Ozempic and Mounjaro and Black patients were 0.69 (0.57-0.84) times as likely to initiate Mounjaro. Patients who completed graduate school were 1.28 (1.06-1.54) times as likely to initiate Wegovy as those who completed high school. Patients who owned their homes were 0.81 (0.68-0.96) times as likely to initiate Wegovy as those who rented, while patients living in multi-family residences, as compared to single family residences, were 0.73 (0.60-0.88) and 0.84 (0.73-0.96) times as likely to initiate Mounjaro and Ozempic, respectively. Patients whose purchasing behavior characterized them as exercise and health conscious were 1.23 (1.08-1.42) times as likely to initiate Ozempic.

Conclusion

This study described associations between SDoH characteristics and the initiation of three GIP/GLP1 treatments in a large US RWD claim data source. As the demand and use of Wegovy, Ozempic, and Mounjaro continues to increase for both medical and cosmetic purposes, it is important to capture a complete profile of the patients most likely to be prescribed these medications. Given the complexity of disease management for type 2 diabetes and the combination of medical, social, and behavioral interventions available for weight loss, effectively measuring short- and long-term outcomes requires the capture of patient data not traditionally available in typical RWD. A more comprehensive understanding of the patient profile using RWD can only be achieved by linking medical records with non-traditional SDoH data sources. In this study, females were more likely than males to initiate all three GIP/GLP1 medications and Black and Hispanic patients were less likely to receive Mounjaro. The use of Wegovy and Mounjaro was associated with higher educational achievement and living in single family residences, potential indicators of higher socioeconomic status, while home ownership was negatively associated with the initiation of Wegovy. These associations are complex and multifaceted and further research will explore interactions between SDoH and clinical characteristics. A strength of case-control studies is the identification all case patients treated patients with Wegovy, Ozempic, or Mounjaro in a large RWD source with a sample of control patients providing the distribution of risks in the underlying population that gave rise to treated pateints. The study efficiently maximizes the use of RWD to measure predictors of a defined outcome validly and reliably. Further analysis will explore the impact of potential misclassification and selection bias present in all analyses of secondary data analyses.