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

METHODS: Retrospective analysis using medical and pharmacy claims data between 11/01/2018-12/31/2020 from commercial and Medicare Advantage with Part D insurance enrollees, age 18+. Patients had ≥1 claim for oral sema (first claim=index date), ≥1 T2DM diagnosis, continuous enrollment for 12 months before and including index (baseline), and 6 months after (follow-up), excluding pregnant females. Utilization was analyzed using a line of therapy (LOT) algorithm that measures treatment regimens over time with descriptive methods.

RESULTS: Patients initiating oral sema (n=1,937) had a mean age of 59 years, 66.5% had commercial insurance and 51.8% were male. All patients had ≥1 LOT, 844 had ≥2 and 89 had 3 LOTs during follow-up. In the 1^st LOT, oral sema monotherapy was initiated by 30.4% of patients for a mean length of 106 days and 23.0% had fills for oral sema+metformin (MET) for a mean length of 141 days. Among patients moving to a 2^nd LOT, at least 19.7% had regimens that included oral semaglutide. Almost half of patients (49.0%) had one LOT until the end of follow-up, and 88.0% of patients with a 2nd LOT continued it to the end of the follow-up period.

CONCLUSIONS: Nearly half of patients used one medication regimen during the 6-month follow-up period. MET was a common concomitant T2DM prescription among patients initiating oral sema. This real-world exploratory study may help physicians and payers understand clinical behavior within the first 6 months of oral sema use.