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. 2025 Jun 30.
doi: 10.1007/s11606-025-09691-4. Online ahead of print.

Prescribing GLPs for Obesity Treatment for Adults at a University Based Health Maintenance Organization by Race, Ethnicity, and Socioeconomic Status

Alissa S Chen  1   2 , Wendy Brunetto  3 , Maureen E Canavan  4 , Kasia J Lipska  5   6 , Elizabeth Richey  3 , Madeline S Wilson  3 , James Zarro  3 , Joseph S Ross  7   5   8   9
Affiliations

Prescribing GLPs for Obesity Treatment for Adults at a University Based Health Maintenance Organization by Race, Ethnicity, and Socioeconomic Status

Alissa S Chen et al. J Gen Intern Med. .

Abstract

Background: While glucagon-like peptide-1 receptor agonists and dual glucagon-like peptide-1 receptor/GIP agonists (GLPs) have revolutionized the treatment of obesity, national data shows Black patients, Hispanic patients, and patients of lower socioeconomic status are less likely to receive anti-obesity medications.

Objective: To assess the association between Black race, Hispanic ethnicity, and low socioeconomic status on GLP prescription receipt for adults in a university-based staff model health maintenance organization (HMO).

Design: Cross-sectional study using electronic health record data.

Participants: Adults (≥ 18 years) enrolled in Yale Health with a body mass index (BMI) ≥ 27 kg/m2 with at least one obesity-related condition or BMI ≥ 30 kg/m2 without diabetes.

Main measures: The main outcome measure was receipt of a GLP prescription for obesity treatment, including subcutaneous liraglutide, semaglutide, or tirzepatide. Main independent variables of interest included self-reported race (Asian, Black, White, Other, and Missing), ethnicity (Hispanic, non-Hispanic), and area deprivation index (ADI) quintile. Three logistic regression models examined the association of race, ethnicity, and socioeconomic status on prescription receipt: 1) an unadjusted model, 2) an adjusted model for age, sex, and clinical characteristics, and 3) an adjusted model with socioeconomic status.

Key results: Among 6,225 eligible patients, 1,143 (18.3%) were prescribed a GLP. Black patients (21.5%) and Hispanic (23.1%) patients had higher prevalence of prescriptions compared to White patients (17.5%; p < 0.001) and non-Hispanic patients (18.1%; p < 0.001). In adjusted models, Black patients (OR = 0.94 [0.78-1.13]) and lowest ADI quintile patients (OR = 0.87 [0.65-1.16]) did not have statistically different odds of receiving a GLP prescription compared to White patients and the highest ADI quintile patients. Hispanic patients had slightly increased adjusted odds of prescription receipt compared to non-Hispanic patients (OR = 1.27 [1.00-1.63]).

Conclusions: In a university-based staff model HMO, there were no disparities in receipt of GLP prescriptions for obesity across racial, ethnic, or socioeconomic groups.

Keywords: Health equity; Obesity; Pharmacoepidemiology.

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Conflict of interest statement

Declarations:. Conflicts of Interest:: Dr. Lipska receives support from CMS to develop and evaluate publicly reported quality measures and royalties from UpToDate to write and edit content. Dr. Ross currently receives research support through Yale University from Johnson and Johnson to develop methods of clinical trial data sharing, from the Food and Drug Administration for the Yale-Mayo Clinic Center for Excellence in Regulatory Science and Innovation (CERSI) program (U01FD005938), from the Agency for Healthcare Research and Quality (R01HS022882), and from Arnold Ventures; formerly received research support from the Medical Device Innovation Consortium as part of the National Evaluation System for Health Technology (NEST); and in addition, Dr. Ross was an expert witness at the request of Relator's attorneys, the Greene Law Firm, in a qui tam suit alleging violations of the False Claims Act and Anti-Kickback Statute against Biogen Inc. that was settled September 2022. Dr. Chen, Ms. Brunetto, Dr. Canavan, Dr. Richey, Dr. Wilson, and Mr. Zarro have no conflicts of interest to disclose. Human Ethics and Consent to Participate:: Yale University Internal Review Board deemed this research to be exempt and granted a full waiver of HIPAA authorization.

References

REFERENCES

    1. Centers for Disease Control and Prevention. Adult Obesity Facts. Accessed August 2, 2024, https://www.cdc.gov/obesity/php/data-research/adult-obesity-facts.html?C...
    1. Heymsfield SB, Wadden TA. Mechanisms, Pathophysiology, and Management of Obesity. New England Journal of Medicine. 2017;376(3):254-266. https://doi.org/10.1056/NEJMra1514009 - DOI - PubMed
    1. Wilding JPH, Batterham RL, Calanna S, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. New England Journal of Medicine. 2021;384(11):989-1002. https://doi.org/10.1056/NEJMoa2032183 - DOI - PubMed
    1. Pi-Sunyer X, Astrup A, Fujioka K, et al. A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management. New England Journal of Medicine. 2015;373(1):11-22. https://doi.org/10.1056/NEJMoa1411892 - DOI - PubMed
    1. Jastreboff AM, Aronne LJ, Ahmad NN, et al. Tirzepatide Once Weekly for the Treatment of Obesity. New England Journal of Medicine. 2022;387(3):205-216. https://doi.org/10.1056/NEJMoa2206038 - DOI - PubMed

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