Prescription trends for obesity medications surge, tied to growing interest in GLP-1 drugs

Monthly prescriptions for obesity medications reached 1.5 million in February 2024, with semaglutide (Wegovy) and tirzepatide (Zepbound) gaining market share as phentermine’s dominance declines

Study: Longitudinal Analysis of Obesity Drug Use and Public Awareness. Image Credit: Artmim/Shutterstock.com

A recent study published in JAMA Network Open finds a strong link between prescription trends of obesity management medications and public online search activities in the United States.

The study suggests that monitoring dispensed prescriptions for these medications through online search activities may be useful in assessing public interest and forecasting future use.

Background

Obesity is a chronic metabolic disease that increases the risk of several other diseases, including type 2 diabetes, cardiovascular disease, chronic kidney disease, liver disease, and certain cancer types.

A body mass index (BMI) of at least 30 kg/m² is defined as obesity. The prevalence of this chronic disease is increasing exponentially worldwide. In the United States, its prevalence has increased from 30% in 2000 to 42% in 2018. The country has also experienced a markedly increased prevalence of very severe obesity, from 4% to 9% during the same period.

Among various efforts to control the obesity epidemic, pharmaceutical interventions have become essential components to achieve sustained weight loss and reduce the risk of comorbidities.

New obesity management medications, including glucagon-like peptide 1 receptor agonists (GLP-1RAs), have shown high efficacy in clinical trials. Among GLP-1RAs, liraglutide and semaglutide have particularly shown high efficacy in promoting satiety, reducing appetite, and regulating blood glucose levels.

The US Food and Drug Administration (FDA) has recently approved the dual GLP-1 and gastric inhibitory polypeptide agonist tirzepatide for weight management.

With the increasing prevalence of obesity, a sharp increase in public online search activities for obesity management medications has been observed in the United States. The highest search activities have been observed for semaglutide, leading to a remarkable surge in demand and subsequent shortage of the medication.

Such induction in public awareness of obesity management medications has raised a concern about supply issues for patients with diabetes who rely on GLP-1RA therapy.

Researchers at the Johns Hopkins University School of Medicine investigated the association between public interest and trends in dispensed prescriptions for obesity management medications.

The primary aim of the study was to understand the implications of this association for forecasting and anticipating the complex dynamics of obesity management medications in the coming years.

Study design

Researchers analyzed online search activities and corresponding data for dispensed prescriptions collected from the IQVIA National Prescription Audit, a comprehensive audit capturing approximately 90% of US retail prescription dispensing that is then projected to population-level data.

They collected both online search data and prescription data of FDA-approved obesity management medications from July 1, 2017, through February 29, 2024. They analyzed data derived from all eligible individuals who used either the Google search engine or received prescriptions. 

Important observations

The study analysis included a total of 69,213,936 prescriptions for obesity medications that were dispensed in the US during the study period. The analysis revealed a steady increase from 0.76 to 0.80 million between July 2017 and June 2018 and from 1.29 to 1.51 million between March 2023 and February 2024.

This sustained induction of dispensed prescriptions for FDA-approved obesity medications reached an annual growth rate of 5.3% during this period.

Among various obesity medications, the highest prescription activity was observed for phentermine, semaglutide, and tirzepatide. By February 2024, approximately 0.74, 0.42, and 0.25 million monthly prescriptions were issued for phentermine, semaglutide, and tirzepatide, respectively.  

The majority of prescriptions were issued by advanced practice practitioners, primary care physicians, and internists. While prescriptions issued by advanced practice practitioners increased from 25.3% in July 2017 to 40.6% in February 2024, a reduction from 57.9% to 48.1% was observed for prescriptions issued by primary care physicians and internists.

Regarding choices made by advanced practice practitioners, primary care physicians, and internists for obesity medications, the study identified semaglutide as the most preferred medication.

The proportion of tirzepatide in dispensed prescriptions also increased considerably by February 2024. However, at the same period, phentermine’s share in prescriptions decreased.

Online search activity for obesity medications

The study found the highest online search activity for semaglutide, followed by tirzepatide and phentermine.

Certain medications that are not primarily approved for obesity management but share the same chemical drug under different brand names and labels were separately analyzed in the study to explore potential off-label applications of GLP-1RAs.

In accordance with the corresponding prescription data, semaglutide had the highest online search activity, followed by tripeptide and liraglutide.

Association between prescription trends and online search activities

The study found significant associations between prescriptions and online search volumes for phentermine, liraglutide, semaglutide, and tirzepatide, with semaglutide and tirzepatide showing the highest associations.

Study significance

The study provides a comprehensive overview of prescription trends and online search activities for FDA-approved obesity management medications.

According to the study findings, semaglutide and tirzepatide are the most preferred obesity medications by the main prescribing specialists, as well as the most frequently searched medications online.

The strongest association between prescriptions and online search volumes observed for semaglutide and tirzepatide highlights the real-time associations between public awareness and prescription trends.

Overall, the study provides a foundation to guide epidemiologic trends and harness real-time search patterns to estimate future trends in the adoption of obesity treatment.