Current Utilization Patterns of Glucagon-Like Peptide-1 Receptor Agonists

Key Messages

• The real-world use of glucagon-like peptide-1 (GLP-1) receptor agonists (RAs), which are funded for type 2 diabetes mellitus (T2DM) across public drug plans in Canada, was analyzed to determine their current utilization patterns and estimate their suspected use outside of T2DM.
• Drug plan expenditures in this drug class have increased significantly in recent months and we wanted to assess the extent of the utilization that was “off reimbursement criteria” (i.e., use outside of T2DM) because these drugs have demonstrated efficacy in other conditions that are not currently publicly funded but have regulatory approval (e.g., weight management).
• Ozempic (semaglutide injection) is the dominant GLP-1 RA brand (> 99% market share among public PT drug plans) and expenditures on it have accelerated. Expenditures on Ozempic have increased from $13.5 million in 2019 to $227 million in 2021.
• Increasing use of Ozempic can be partially attributed to non-T2DM claims. The proportion of claimants with suspected use outside of T2DM was 15% in Ontario and ranged from 0% to 8% across the other PT public drug plans; suspected use outside of T2DM is projected to be 1 in 5 claimants in Ontario in 2022. Among non-formulary claims (e.g., federal public plans, private insurance), this proportion ranged from 36% to 74% (data from 2021).