Public insurance coverage recipients much less more likely to obtain diabetes and weight problems drug, research reveals

A brand new USC research means that publicly insured people who’re more than likely to learn from new medication for diabetes and weight problems are much less more likely to get them than these with non-public insurance coverage.

Prescription fills for the drug finest often known as Ozempic or Wegovy -; semaglutide -; elevated by greater than 400% between January 2021 and December 2023, in accordance with analysis out right now in JAMA Well being Discussion board.

Authorized first for sort 2 diabetes, then for weight reduction, research present that semaglutide additionally improves blood strain and reduces heart problems -; issues that plague thousands and thousands of People. But the lion’s share of prescriptions went to folks with non-public insurance coverage.

Given the confirmed cardiovascular advantages of Ozempic and Wegovy when used for diabetes or weight problems, and the disproportionate burden of diabetes and weight problems in Black/Latinx Medicaid and Half D populations, these findings counsel that their decrease use in Medicaid and Half D could worsen disparities in diabetes and weight problems outcomes.”

Dima Qato, senior creator, affiliate professor on the USC Mann College of Pharmacy & Pharmaceutical Sciences and senior scholar on the USC Leonard D. Schaeffer Middle for Well being Coverage & Economics

“I believe all the present consideration within the media on semaglutide’s anti-obesity impact obscures the truth that the drug can be vastly essential for treating diabetes. It is the explanation why I have been in a position to get a few of my sufferers off insulin,” mentioned first creator Christopher Scannell, a doctor and postdoctoral researcher on the Schaeffer Middle. “If solely sure affected person populations get entry to those drugs -; these primarily with non-public insurance coverage, extra beneficiant well being plans -; then there’s an enormous proportion of the U.S. inhabitants that is not gaining access to these drugs. And that brings up a really vital fairness difficulty.”

Ozempic and Wegovy are once-weekly injections. One other type of semaglutide, Rybelsus, is a every day tablet. Ozempic was authorized in 2017, adopted by Rybelsus in 2019, to deal with sort 2 diabetes. Wegovy, authorized 2021, is a higher-dose model that is particularly authorized for weight reduction. Ozempic’s sticker worth is about $1,000 monthly, whereas Wegovy is listed round $1,350.

For the research, researchers used knowledge from IQVIA’s Nationwide Prescription Audit PayerTrak, which captures 92% of prescriptions stuffed and disbursed to people at retail pharmacies in the USA.

Then, they calculated month-to-month fills for semaglutide by drug model (Ozempic, Wegovy, and Rybelsus) and by fee technique (industrial insurance coverage, Medicaid, Medicare Half D, and money) between January 2021 and December 2023.

Prescription fills reached 2.6 million by December 2023. Ozempic persistently accounted for many of the prescriptions, however prescription fills for Wegovy, authorized for weight reduction in June 2021, soared by greater than 1,361% between July 2021 and December 2023. Consciousness of the medication’ weight-loss advantages shot up in late 2022 and sure contributed to shortages of Ozempic and Wegovy, first reported by the FDA in March 2022.

• Medicaid accounted for lower than 10% of semaglutide fills for all three drug manufacturers in 2023. Entry through Medicaid is a state-level choice, Scannell mentioned. Relying on the price range -; and politics -; of the place you reside, the medication could or will not be coated. (Medicaid offers help to low-income folks, the aged and a few folks with disabilities.)
• Medicare Half D accounted for 28.5% and 32.9% of Ozempic and Rybelsus fills, respectively, in 2023; it solely accounted for 1.2% of Wegovy fills. Medicare Half D does not cowl the medication for weight problems except a affected person additionally has a co-morbidity comparable to heart problems as effectively -; the very drawback Wegovy or Ozempic can stop.
• Roughly 1% or much less of all semaglutide fills went to folks paying money in 2023.

Within the context of treating weight problems, Scannell mentioned, “if Medicare is just masking these medication for sufferers who’ve weight problems and a co-morbidity, it might be forcing sufferers who solely have weight problems to develop these further persistent situations earlier than they’ll get entry to the drugs. It is like saying ‘It’s a must to be sick sufficient, then we’ll cowl that medicine for you.'”

The researchers mentioned future research ought to study how modifications in Medicare Half D and Medicaid protection restrictions affect disparities in entry to those important drugs. As well as, additional analysis may study individual-level variables comparable to age, race, and ethnicity and whether or not the medication have been prescribed for weight problems or diabetes.

Along with Scannell and Qato, different authors embody John Romley, Rebecca Myerson and Dana Goldman, all of USC.