OBJECTIVES: There has been tremendous public interest in the use of glucagon-like peptide receptor agonists (GLP-1 RAs) given their efficacy in weight loss. Ozempic® (semaglutide), which only has a type 2 diabetes indication, is potentially being used for off-label in several disease areas. Monitoring trends in GLP-1 RA prescribing practices is critical to understand and inform pharmacovigilance efforts on this and similar drug classes, especially as more products gain FDA approval.

METHODS: IQVIA’s syndicated data assets, National Prescription Audit (NPA) and National Medical and Treatment Audit (NMTA), were used to investigate utilization trends for all GLP-1 Ras. Analyses were conducted at the brand and molecule level. NPA was interrogated for national and regional prescriptions dispensed data; NPA – Extended Insights was used for provider specialty data. NMTA was used for diagnosis codes associated with prescriptions written from office-based medical practices.

RESULTS: In 2023 (through November) there were >50 million prescriptions dispensed for GLP-1 RAs, with Ozempic® representing ~39% of the prescriptions. From 2018 to 2023, ~60% of Ozempic® prescriptions were dispensed to female patients, with nearly all dispensed to those 40-59 (~48%) and 60+ years old (~42%). In 2023, nurse practitioners (NPs) were the largest prescribers, followed by primary care providers (PCPs). Ozempic® was the only GLP-1 RA brand in the class with readily identifiable off-label prescribing, increasing from ~22% in 2018 to ~30% in 2023. Nearly all off-label use was for obesity and/or body mass index.

CONCLUSIONS: Ozempic® is currently used off-label more than any other GLP-1 RA, and the proportion has increased, driven largely by NPs and PCPs prescribing to treat obesity-related conditions. However, other off-label uses are emerging, including in alcohol abuse and women’s health. More research is needed on the downstream clinical and public health effects of increased off-label prescribing of Ozempic®.