OBJECTIVES: Characterize medication use patterns among patients with T2DM initiating OW semaglutide (sema).

METHODS: Retrospective analysis using medical and pharmacy claims data between 01/01/2017-12/31/2020 for commercial and Medicare Advantage with Part D insurance enrollees, age 18+. Patients had ≥1 claim for OW sema (first claim=index date), ≥1 T2DM diagnosis, continuous enrollment for 12 months before and including index (baseline) and 12 months after (follow-up), excluding pregnant females. Medication use was analyzed using a line of therapy (LOT) algorithm that measures regimens over time with descriptive methods.

RESULTS: Patients initiating OW sema (n=15,588) had a mean age of 59 years, 60.8% had commercial coverage and 52.2% were female. All patients had ≥1 LOT, 9,071 (58.2%) had ≥2 and 3,866 (24.8%) had ≥3 LOTs during follow-up. OW sema monotherapy was initially filled by 31.9% of patients with a mean length of 180 days. OW sema+metformin (MET) was filled by 24.4% of patients with a mean length of 237 days. Over one-third (36.5%) had 1 LOT until the end of follow-up and 37.4% began a 2^nd LOT by switching a medication. In the 2^nd LOT, OW sema monotherapy was filled by 18.5% of patients with a mean length of 136 days, and OW sema+MET was filled by 11.2% with a mean length of 159 days. 52.1% of patients who had a 2^nd LOT continued it to the end of the follow-up period.

CONCLUSIONS: OW sema monotherapy and OW sema+MET were the most commonly filled T2DM LOTs among patients initiating OW sema. Most patients had 1 or 2 regimens during the 12-month follow-up period. This real-world exploratory study may help physicians and payers understand clinical behavior within the first year of OW sema use.