127-LB: Real-World A1C Changes and Prescribing Provider Types among T2DM Patients Initiating Treatment with Oral Semaglutide

Purpose: To describe A1c changes and characteristics of patients with type 2 diabetes mellitus (T2DM) initiating oral semaglutide (sema) , by baseline A1c ≥9% and <9%.

Methods: Retrospective analysis using medical and pharmacy claims data from 11/01/2018-12/31/2020 from commercial and Medicare Advantage with Part D enrollees, aged 18+. Patients had ≥1 claim for oral sema (first claim=index date) , ≥1 T2DM diagnosis, continuous enrollment for 12 months before and including index (baseline) , and 6 months post-index (follow-up) , pregnant females excluded. Results were stratified by patient’s last baseline A1c (< or ≥9%) .

Results: Patients initiating oral sema who had ≥1 baseline A1c (n=994) had a mean age of 59 years, 50.4% were male, and 63.1% had commercial coverage. Among patients with baseline and follow-up A1c values (n=652) , mean A1c change was -0.8% (1.49) . Among a subset with ≥90 days of continuous oral sema treatment and ≥1 A1c after ≥90 days of treatment (n=200) , the A1c ≥9% group had a mean A1c change of -2.7% (2.1) . While half of index treatments were prescribed by primary care and internal medicine providers (50.6% overall) , a higher percentage of patients with A1c <9% had oral sema prescribed by an endocrinologist (24.4% vs. 16.1%; p=0.006) .

Conclusions: Results suggest that oral sema is an effective T2DM treatment in the real-world, especially among patients with A1c values ≥9% prior to treatment initiation. Patients with T2DM in this population are more often prescribed oral sema by primary care physicians than endocrinologists.