SAT-529 Real-world Treatment Patterns Of Tirzepatide Versus Semaglutide In GLP-1 RA-experienced Patients With T2D

Abstract Disclosure: K. Terrell: Eli Lilly & Company. C. Vallarino: Eli Lilly & Company. J.M. Maldonado: Eli Lilly & Company. M. Grabner: Carelon Research, Elevance Health. C. Teng: Carelon Research, Elevance Health, Eli Lilly & Company. M. Hoog: Eli Lilly & Company. E. Richard: Carelon Research, Elevance Health. Introduction and objective: Adherence and persistence with antihyperglycemic medications are associated with improved glycemic control, lower rates of microvascular and macrovascular complications, and lower healthcare resource utilization. This real-world study analyzed treatment patterns among glucagon-like-peptide-1 receptor agonist (GLP-1 RA)-experienced patients with T2D initiating tirzepatide or semaglutide. Methods: This retrospective cohort study used claims and clinical data from the Healthcare Integrated Research Database (HIRD®) to identify patients with T2D initiating any dose of either tirzepatide or injectable semaglutide indicated for T2D (index medication) from May 13, 2022 to May 29, 2023. Patients had at least 6 months continuous enrollment before and 12 months after initiation (index date) and ≥1 pharmacy claim for a non-index GLP-1 RA during the 6-month pre-index period. Baseline characteristics across the two cohorts were balanced by 1:1 propensity score matching. Adherence (proportion of days covered ≥0.80), persistence (≤45-day gap in days covered), and switching were analyzed across the 12-month post-index period. Results: Each cohort had 5,577 patients after matching (tirzepatide: mean age 55 years, 55% males; semaglutide: mean age 55 years, 54% males). Both cohorts were predominantly white (74% tirzepatide, 73% semaglutide) and over 90% had commercial insurance. Tirzepatide initiators had more index medication fills (mean [SD]: 9.2 [4.05] vs. 6.8 [3.82]; p<0.001) and a greater proportion were adherent (66% vs. 48%; p<0.001) than semaglutide initiators. More tirzepatide initiators were persistent to index medication (68% vs. 49%, p<0.001) and remained on treatment for longer (mean [SD] persistent days: 289 [123.7] vs. 248 [132.6]; p<0.001) than semaglutide initiators. Among patients who discontinued (1,765 tirzepatide and 2,822 semaglutide), some restarted the index medication (tirzepatide: 46%; semaglutide: 39%; p<0.001) and/or switched to another GLP-1 RA (tirzepatide: 52%; semaglutide: 56%; p<0.05). Among those who switched, most tirzepatide initiators switched to dulaglutide (45%) or semaglutide (43%), while most semaglutide initiators switched to tirzepatide (48%) or dulaglutide (43%). Conclusion: This real-world study demonstrated that among GLP-1 RA-experienced patients with T2D, tirzepatide initiators had more index medication fills, greater adherence and longer persistence than semaglutide initiators over the 12-month post-index period. Presentation: Saturday, July 12, 2025