128-LB: Real-World A1C Changes and Prescribing Provider Types among T2DM Patients Initiating Treatment with Once-Weekly (OW) Semaglutide

Purpose: Characterize A1c changes and characteristics among patients with T2DM initiating OW semaglutide (sema) , by baseline A1c ≥9% and <9%.

Methods: Retrospective analysis using medical and pharmacy claims data between 01/01/2017-12/31/2020 from commercial and Medicare Advantage with Part D insurance enrollees, age 18+. Patients had ≥1 claim for OW sema (first claim=index date) , ≥1 T2DM diagnosis, continuous enrollment for 12 months before and including index (baseline) and 12 months after (follow-up) and were excluded if pregnant. Results were stratified by whether patient’s last baseline A1c value was ≥ or <9%.

Results: Patients initiating OW sema with ≥1 baseline A1c value (n=7,653) had a mean age of 59 years, 51.4% were female, and 62.5% had commercial coverage. Among patients with baseline and follow-up A1c value (n=6,042) , mean A1c change was -0.8 (1.6) . Among a subset of patients with ≥90 days of continuous OW sema treatment and at least 1 A1c value after 90 days of treatment (n=3,456) , the A1c ≥9% group had a mean A1c reduction -2.5%. While many study patients had index claims prescribed by primary care and internal medicine providers (46.1% overall) , a higher percentage of patients with A1c <9% had OW sema prescribed by an endocrinologist (28.5% vs. 25.5%; p=0.008) .

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