SAT-528 Real-world Treatment Patterns Of Tirzepatide Versus Semaglutide In GLP-1 RA-naive Patients With T2D

Abstract Disclosure: M. Hoog: 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 and Company. K. Terrell: Eli Lilly & Company. E. Richard: Carelon Research, Elevance Health. Introduction and objective: Persistence and adherence to 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)-naive 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 no pharmacy claims for a 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 10,702 patients after matching (tirzepatide: mean age 53 years, 56% males; semaglutide: mean age 53 years, 55% males). Both cohorts were predominantly white (71%) and had commercial insurance (92%). Tirzepatide initiators had more index medication fills (mean [SD]: 8.9 [4.36] vs. 6.8 [3.89]; p<0.001) and a greater proportion were adherent (60% vs. 45%; p<0.001) than semaglutide initiators. More tirzepatide initiators were persistent to index medication (62% vs. 47%, p<0.001) and remained on treatment longer (mean [SD] persistent days: 271 [132.9] vs. 239 [135.4]; p<0.001) than semaglutide initiators. Among patients who discontinued (4,065 tirzepatide and 5,624 semaglutide), some restarted the index medication (tirzepatide: 43%; semaglutide: 46%; p=0.014) and/or switched to another GLP-1 RA (tirzepatide: 27%; semaglutide: 25%; p<0.01). Among those who switched, most tirzepatide initiators switched to semaglutide (64%) or dulaglutide (23%), while most semaglutide initiators switched to tirzepatide (55%) or dulaglutide (26%). Conclusion: In this real-world study, among GLP-1 RA-naive patients with T2D, tirzepatide initiators had more index medication fills, and a greater proportion were adherent to and persistent on index medication than semaglutide initiators over the 12-month post-index period. Presentation: Saturday, July 12, 2025