Association of patient characteristics and insurance type with anti‐obesity medications prescribing and fills
Open accessAbstract
Aim: To characterize factors associated with the receipt of anti‐obesity medication (AOM) prescription and fill. Materials and Methods: This retrospective cohort study used electronic health records from 1 January 2015 to 30 June 2023, in a large health system in Ohio and Florida. Adults with a body mass index ≥30 kg/m 2 who attended ≥1 weight‐management programme or had an initial AOM prescription between 1 July 2015 and 31 December 2022, were included. The main measures were a prescription for an AOM (naltrexone‐bupropion, orlistat, phentermine‐topiramate, liraglutide 3.0 mg and semaglutide 2.4 mg) and an AOM fill during the study follow‐up. Results: We identified 50 678 adults, with a mean body mass index of 38 ± 8 kg/m 2 and follow‐up of 4.7 ± 2.4 years. Only 8.0% of the cohort had AOM prescriptions and 4.4% had filled prescriptions. In the multivariable analyses, being a man, Black, Hispanic and other race/ethnicity (vs. White), Medicaid, traditional Medicare, Medicare Advantage, self‐pay and other insurance types (vs. private insurance) and fourth quartile of the area deprivation index (vs. first quartile) were associated with lower odds of a new prescription. Hispanic ethnicity, being a man, Medicaid, traditional Medicare and Medicare Advantage insurance types, liraglutide and orlistat (vs. naltrexone‐buproprion) were associated with lower odds of AOM fill, while phentermine‐topiramate was associated with higher odds. Among privately insured individuals, the insurance carrier was associated with both the odds of AOM prescription and fill. Conclusions: Significant disparities exist in access to AOM both at the prescribing stage and getting the prescription filled based on patient characteristics and insurance type.
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From 2015 to 2023, only 8.0% of adults received AOM prescriptions and 4.4% filled them.
“Between 2015 to 2023, only 8.0% of adults had AOM prescriptions, and just 4.4% filled their prescriptions.”
From Regional trends and disparities in newer <scp>GLP1</scp> receptor agonist initiation among real‐world adult patients eligible for obesity treatment (2025) · cites this paper as [11]
The lower initiation rate compared with Gasoyan's study is likely explained by differences in inclusion criteria.
“likely due to differences in inclusion criteria”
From Regional trends and disparities in newer <scp>GLP1</scp> receptor agonist initiation among real‐world adult patients eligible for obesity treatment (2025) · cites this paper as [11]
Privately insured patients were more likely to receive and fill AOM prescriptions.
“individuals with private insurance were more likely to receive both AOM prescriptions and have them filled (11).”
From Regional trends and disparities in newer <scp>GLP1</scp> receptor agonist initiation among real‐world adult patients eligible for obesity treatment (2025) · cites this paper as [11]
Only 2% of patients started AOMs, which is lower than the 8% reported by Gasoyan et al.
“only 2% of patients initiated AOMs, despite the exponential growth of newer AOM use. This is lower than the 8% reported in Gasoyan’s study”
From Regional trends and disparities in newer <scp>GLP1</scp> receptor agonist initiation among real‐world adult patients eligible for obesity treatment (2025) · cites this paper as [11]
Non-Hispanic White patients had higher odds of being prescribed an AOM than non-Hispanic Black, Hispanic, and other racial or ethnic groups.
“non-Hispanic Whites had higher odds of being prescribed an AOM compared to non-Hispanic Blacks, Hispanics, and other racial or ethnic groups”
From Regional trends and disparities in newer <scp>GLP1</scp> receptor agonist initiation among real‐world adult patients eligible for obesity treatment (2025) · cites this paper as [11]
Among those who filled AOM prescriptions, 39% received naltrexone/bupropion, 29% phentermine-topiramate, 19% semaglutide, 11% liraglutide, and 1.2% orlistat.
“Among those who filled prescriptions, 39% received naltrexone/bupropion, 29% phentermine-topiramate, 19% semaglutide, 11% liraglutide, and 1.2% orlistat (11).”
From Regional trends and disparities in newer <scp>GLP1</scp> receptor agonist initiation among real‐world adult patients eligible for obesity treatment (2025) · cites this paper as [11]
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- Authors
- Gasoyan, H., Pfoh, E. R., Schulte, R., Sullivan, E., Le, P., & Rothberg, M. B.
- Affiliations
- Cleveland Clinic (US)
- Cleveland Clinic Lerner College of Medicine (US)
- Corresponding author
- Gasoyan, Hamlet
- Venue
- Diabetes, Obesity and Metabolism
- Publisher
- Wiley
- Published
- 2024-01-29
- Volume
- 26
- Issue
- 5
- Pages
- 1687-1696
- ISSN
- 1462-8902 (ISSN-L)
- 1463-1326
- PMC
- PMC11001528
- OpenAlex
- W4391359437
- Cited by
- 41
- References
- 37
- Citations by year
- 2026: 20 · 2025: 14 · 2024: 7
- FWCI
- 11.58
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Obesity and Metabolism (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Cancer Institute (1K99CA277136‐01)
- Topics
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Keywords
- anti-obesity drugs, prescription fills, health insurance type, Medicaid, Medicare, racial and ethnic disparities, socioeconomic deprivation, Area Deprivation Index, naltrexone/bupropion, orlistat, phentermine/topiramate, liraglutide, semaglutide
- MeSH terms
- Liraglutide, Topiramate, Orlistat, Adult, Aged, Humans, Naltrexone, Phentermine, Retrospective Studies, United States, Anti-Obesity Agents, Medicare Part C
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