1236 Impact of Pharmacy Support on Tirzepatide Management in Patients with Obstructive Sleep Apnea or Obesity

Abstract Introduction Zepbound® (tirzepatide) is a newly indicated treatment option for moderate to severe obstructive sleep apnea (OSA) and obesity. In our pharmacist-supported clinics, pharmacists assist with prior authorizations (PA) and medication titration, aiming to streamline access and optimize therapy. This study evaluated the impact of pharmacist-supported clinics compared to non-supported clinics on BMI reduction, PA completion, and titration patterns in patients prescribed tirzepatide. Methods A retrospective review included 94 adults (≥18 years) prescribed tirzepatide by cardiology or sleep medicine providers. A report was generated capturing all patients who had an active tirzepatide prescription between May 1 and May 31, 2025, even if the medication had been prescribed earlier. Patients were categorized into two groups: pharmacist-supported clinics and non-supported clinics. The primary outcome was change in BMI from baseline to follow-up. Secondary outcomes included PA completion, denial rates, and adherence to recommended titration schedules. Paired t-test was utilized to compare differences in mean. Results Of 94 patients, 72 (77%) were managed in pharmacist-supported clinics and 22 (23%) in non-supported clinics; 72 (77%) were treated for OSA and 22 (23%) for weight management. Overall, mean BMI reduction was 2.07 kg/m² in the pharmacist-supported group (p< 0.001) versus 1.12 kg/m² in the non-supported group (p>0.14). Among OSA patients, mean BMI reduction was 2.9 kg/m² in the pharmacist-supported group (p>0.12) versus 0.6 kg/m² in the non-supported group (p>0.06). PA completion occurred in 71 (99%) pharmacist-supported cases versus 14 (64%) in the other group. 33 (46%) prior authorizations were denied in the pharmacist-supported group and 13 (59%) were not completed or denied in the other group. 59 patients started tirzepatide (48 pharmacist-supported, 11 non-supported). Appropriate titration occurred in 47 (98%) pharmacist-supported patients compared to 4 (37%) in the non-supported group; 3 (27%) in the latter group were not titrated. Conclusion These preliminary findings suggest that pharmacist-supported clinics may improve BMI reduction, prior authorization completion, and adherence to titration schedules in patients prescribed tirzepatide for OSA and obesity. By managing medication access and optimization, pharmacists can help providers focus on clinical decision-making and work at the top of their license. Support (if any)