Late-Stage Persistence With Anti-Obesity Medication Varies By Medication, Weight Loss At 6 Months

A team of researchers found that patients using anti-obesity medications (AOM) may not persistently use the medication beyond 1 year after the initial prescription.

A retrospective cohort study was conducted to examine the percentage of patients with an initial AOM fill who were persistent with the medication at 3, 6 and 12 months. The researchers aimed to characterize the factors associated with persistence at 1 year.

The researchers used electronic health records from January 2015 to July 2023 in a large health system in Ohio and Florida for the study’s data. In total, 1911 adult participants were included with a BMI of 30 kg/m2  who had an initial AOM prescription filled between 2015 and 2022. The median baseline BMI in the study was 38 (IQR 34 – 44).

At 3 months, 44% of patients were persistent with AOM, 33% at 6 months, and 19% at 12 months. The highest 1-year persistence was seen in patients receiving semaglutide for treatment (40%). Further, naltrexone-bupropion was associated with lower odds when compared with phentermine-topiramate. The results also showed that persistence at 1 year varied based on the achieved weight loss at 6 months as well as by the insurance carrier among those who had private insurance.

This study had limitations. The authors noted that Medicaid and marketplace health insurance plans for AOM vary by state, as do sociodemographic factors, which may limit the generalizability of their findings.

“Although later-stage persistence with AOM remains low, patients receiving the newer, more effective forms of AOM and those experiencing greater medium-term weight loss are more likely to persist,” the researchers wrote.

The researchers also made it clear that future work is still needed.

“Future studies should examine determinants of nonpersistence with AOM, ways to help increase persistence, and the role of specific insurance design features in continuous access to AOM,” they concluded.

Reference:
Gasoyan H, Pfoh ER, Schulte R, Le P, Rothberg MB. Early- and later-stage persistence with antiobesity medications: a retrospective cohort study. Obes. Published online December 6, 2023. doi:10.1002/oby.23952