OBJECTIVES: Tirzepatide, a dual GLP-1 RA/GIP, received FDA approval as an anti-obesity medication (AOM) in November 2023 and became available in US pharmacies in December. While tirzepatide labeled for obesity (AOM tirzepatide) has both a lower list price and higher placebo-controlled effectiveness than AOM semaglutide, insurance coverage for both AOMs remains limited and monthly list prices exceed $1,000, potentially limiting access. We describe uptake and patient characteristics for AOM tirzepatide.

METHODS: Using US EHR from Truveta, we identified a cohort of patients eligible for AOM tirzepatide: adults with an encounter in December 2023 and overweight (BMI ≥27) or obesity (BMI ≥30) in the previous 60 days. We restricted to patients with at least one dispense of any medication. Data included EHR (encounters, prescriptions, conditions, BMI), medication dispensing, and social drivers of health (SDOH) for a collective of US healthcare systems. We describe the number and percentage of patients newly prescribed AOM tirzepatide, including demographics, comorbidities, income and previous use (dispense) of other GLP-1 RA.

RESULTS: Of 1,721,466 eligible patients, 2,541 (0.15%) were newly prescribed AOM tirzepatide. The majority were female (79%) and white (78%), with a mean(SD) age of 47(11.8). Common comorbidities included hyperlipidemia (46%), hypertension (44%), and major depression (17%). Overall, 41% had previously used a different GLP-1 RA; 18% used AOM semaglutide, 15% used anti-diabetic medication (ADM) tirzepatide, and 8% used ADM semaglutide (not mutually exclusive). Of those with non-missing income (81%), 7% had individual incomes ≤$30,000.

CONCLUSIONS: While many patients were prescribed AOM tirzepatide immediately following approval, uptake as a proportion of the eligible population remained small and switching from AOM semaglutide was not common. Those newly prescribed AOM tirzepatide were primarily female and white, and few had incomes ≤$30,000, which differs from the population most impacted by obesity. Continued monitoring of uptake and equitable access is needed.