MON-689 Medication Access and Outcomes for Real-World Treatment of Obesity and Diabetes with GLP-1s

Abstract Disclosure: K.L. Medeiros: None. K. Boyd: None. Increasing evidence demonstrates the effectiveness of GLP-1 receptor agonist medications (GLP-1s) in treating obesity and associated metabolic conditions. However, real-world access to GLP-1 treatment is a challenge. Insurance coverage is difficult to navigate, leaving many patients untreated or with interruptions to medication access. Pharmaceutical manufacturers have also experienced numerous supply shortages. We evaluated patient cohorts in a digital commercial metabolic health program combining GLP-1 and ILI to assess GLP-1 access and treatment outcomes. Patients in an entirely digital program were treated with GLP-1s and potential adjunct metformin in combination with a proprietary intensive lifestyle intervention. Medication selection was determined by physicians based on clinical appropriateness as well as insurance coverage and medication inventory. Patients with at least one GLP-1 fill who exclusively utilized partner pharmacies for their prescriptions were eligible for evaluation. In addition to weight, metabolic markers, and patient-reported outcomes, we assessed medication access and disruptions. For the n=6,392 patients who completed at least 12 months (mo), it took an average of 5.46 weeks into the program for patients to start GLP-1 therapy, and they received an average of 8.13 GLP-1 fills in the first 12mo. In evaluating subsets of this cohort, patients with diabetes received 8.41 fills (n=132) and prediabetes 8.24 fills (n=1,052). Patients who were in the program for two years had an average of 15.25 fills (n=1,554). On average, patients accessed 1.36 different GLP-1 medications (range: 1-5), with Ozempic being the most commonly filled medication (55%), followed by Wegovy and Mounjaro. Patients with diabetes and prediabetes had similar access patterns at 1.35 fills and 1.37 fills, respectively. In this analysis, 72.5% of patients (n=4,633) experienced at least one medication disruption (defined as at least 13 weeks without GLP-1 access) and 11.1% experienced multiple disruptions. Patients with medication disruptions achieved an average weight loss of 13.7% at 12 months and 14.9% at 24 months, compared to 17.0% at 12 months and 20.1% at 24 months for those without disruptions. Patients with 1-4 GLP-1 fills in the first program year lost >10% of body weight at 12 mo (n=339), regardless of glycemic status at intake. Patients with 4-6 GLP-1 fills over 24 months lost 15.4% at 12 mo (n=62) and 19% at 24 months (n=31). Despite mounting clinical trial data and commercial attention, GLP-1 access continues to be a challenge for patients with obesity as well as for patients with obesity and diabetes. Clinically significant weight loss was achieved through this commercial program combining GLP-1s with ILI and 1:1 coaching, even in the setting of limited GLP-1 fills and/or medication disruptions. Presentation: Monday, July 14, 2025