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. 2025 Jul;16(7):1479-1495.
doi: 10.1007/s13300-025-01739-2. Epub 2025 May 28.

Perceptions and Attitudes Toward Oral Semaglutide Among Japanese Physicians and Individuals with Type 2 Diabetes: A Web-Based Survey

Ryo Suzuki  1 , Krishant Chand  2 , Yuu Taguchi  2
Affiliations

Perceptions and Attitudes Toward Oral Semaglutide Among Japanese Physicians and Individuals with Type 2 Diabetes: A Web-Based Survey

Ryo Suzuki et al. Diabetes Ther. 2025 Jul.

Abstract

Introduction: The oral formulation of the glucagon-like peptide-1 receptor agonist semaglutide has dosing requirements that could impact adherence. We compared perceptions of physicians and individuals with type 2 diabetes (T2D) in Japan, before and after initiating oral semaglutide, with respect to adherence to dosing requirements.

Methods: In this observational study, online questionnaires were completed by treating physicians and adults with T2D who had received either oral semaglutide or other oral antidiabetic medications for ≥ 6 months. Physicians reported the expected adherence of their patients to oral semaglutide and expected patient difficulties around the dosing requirements prior to (baseline) and after (time of survey) initiating oral semaglutide. Patient-reported adherence and difficulties experienced with the dosing requirements were assessed after oral semaglutide was initiated.

Results: Overall, 330 physicians and 412 individuals with T2D responded. There was a statistically significant difference (P < 0.001) between baseline and time of survey in the distribution of physicians who expected that ≥ 80% or < 80% of their patients would adhere to oral semaglutide, with 17.2% of physicians expecting ≥ 80% of their patients to be adherent before treatment initiation versus 44.6% reporting ≥ 80% of their patients to be adherent after treatment initiation. There was also a statistically significant difference (P < 0.001) in the distribution of expected versus reported adherence among individuals who received oral semaglutide. After semaglutide initiation, 95.2% of patients reported missing ≤ 1 dose/week. Before prescribing oral semaglutide, 186 (56.4%) physicians were resistant to it, due to the dosing requirements. After prescribing oral semaglutide, 146 (44.2%) reported their resistance had decreased, whereas only 28 (8.5%) reported increased resistance.

Conclusions: We identified an improvement in physician perceptions of oral semaglutide adherence due to dosing requirements following semaglutide initiation. Our findings suggest that individuals with T2D in Japan are capable of adhering to the dosing requirements of oral semaglutide.

Keywords: Drug administration; Japan; Medication adherence; Oral semaglutide; Patient attitude; Physician perspective.

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Conflict of interest statement

Declarations. Conflict of Interest: Ryo Suzuki: received lecture fees from Astellas Pharma Inc., Eli Lilly Japan K.K., Kowa Company Ltd., Mitsubishi Tanabe Pharma Corporation, MSD K.K., Novo Nordisk Pharma Ltd., Sanofi K.K., Sumitomo Pharma Co., Ltd., Teijin Healthcare Ltd.; and grants from Nippon Boehringer Ingelheim Co., Ltd., Krishant Chand and Yuu Taguchi are employed by Novo Nordisk Pharma Ltd. Yuu Taguchi is a shareholder in Novo Nordisk Pharma Ltd. Ethical Approval: The study was conducted in accordance with the Declaration of Helsinki and the Guidelines for Good Pharmacoepidemiology Practices. The study protocol, consent forms, and questionnaires were approved by an independent ethics committee of the Research Institute of Healthcare Data Science (approval number RI2023005) on December 4, 2023. All respondents provided informed consent online, and were made aware and gave consent that their responses would be published in a medical journal. All personal information was managed by Macromill, Inc. (Tokyo, Japan), was used solely for the purposes of this study, and was not provided to the study sponsor.

Figures

Fig. 1
Fig. 1
a Physicians’ perceptions of the proportion of their patients that would adhere to the oral semaglutide dosing requirements at baseline and at the time of survey. b Individuals with T2D who expected to be adherent to the oral semaglutide dosing requirements, at baseline. c Individuals with T2D who were not adherent to the dosing requirements at the time of survey (among individuals receiving oral semaglutide). Data sets (a–c) include all individuals, including those who responded “do not know” or “do not remember” at baseline or time of survey. CI confidence interval, T2D type 2 diabetes
Fig. 2
Fig. 2
Difficulties expected with the oral semaglutide dosing requirements at baseline. a Proportion of physicians expressing concerns with dosing requirements (N = 330). b Proportion of individuals with T2D reporting concerns with the dosing requirements (N = 412). ADR adverse drug reaction, CKD chronic kidney disease, CVD cardiovascular disease, T2D type 2 diabetes
Fig. 3
Fig. 3
Difficulties reported with the oral semaglutide dosing requirements after initiating oral semaglutide, at the time of survey. a Difficulties reported by physicians. b Difficulties reported by individuals with T2D (only among individuals prescribed oral semaglutide; n = 206). c Dosing requirements leading to non-adherence as reported by physicians. T2D type 2 diabetes
Fig. 4
Fig. 4
Shifts in physician resistance to prescribing oral semaglutide due to the dosing requirements, from baseline to the time of survey. a Physicians (%) with resistance at baseline (N = 330). b Physicians (%) expressing a change in their resistance at the time of survey (N = 330). c Physicians (%) who stated how many individuals with T2D they had treated with oral semaglutide before their resistance changed (n = 174). T2D type 2 diabetes
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