A recent study from the University of Southern California reveals that publicly insured individuals who are most likely to benefit from new medications for diabetes and obesity have less access to them compared to those with private insurance. The research, published today in JAMA Health Forum, shows a surge in prescriptions for semaglutide—known commercially as Ozempic or Wegovy—by over 400% from January 2021 to December 2023. Initially approved for type 2 diabetes and later for weight loss, semaglutide also improves blood pressure and reduces cardiovascular disease risks, which are prevalent among millions of Americans. Despite these benefits, most of the prescriptions are distributed to those with private insurance.
Dima Qato, the study’s senior author and associate professor at the USC Mann School of Pharmacy & Pharmaceutical Sciences, pointed out the significant cardiovascular benefits of Ozempic and Wegovy in treating diabetes and obesity. He emphasized that the lower usage of these drugs in Medicaid and Part D populations, which have a higher incidence of these conditions among Black/Latinx communities, could worsen health disparities. Christopher Scannell, a physician and postdoctoral researcher at the Schaeffer Center and the study’s first author, expressed concerns over the equity of drug access. He highlighted that the media’s focus on semaglutide’s anti-obesity effects might obscure its crucial role in diabetes management, which is essential for some patients to discontinue insulin use.
Ozempic and Wegovy are administered weekly injections, whereas Rybelsus, another semaglutide formulation, takes them daily. Ozempic was first approved in 2017, followed by Rybelsus in 2019 to treat type 2 diabetes, with Wegovy coming in 2021 specifically for weight loss at a higher dosage. These medications are priced steeply, with Ozempic at around $1,000 monthly and Wegovy at approximately $1,350.
The data for this study was sourced from IQVIA’s National Prescription Audit PayerTrak, which records 92% of all prescriptions filled at retail pharmacies in the U.S. The researchers examined the monthly prescription data by brand and payment method—covering commercial insurance, Medicaid, Medicare Part D, and cash payments—from January 2021 through December 2023. By the end of 2023, prescription totals reached 2.6 million, with a remarkable increase in Wegovy prescriptions due to heightened awareness of its weight-loss benefits.
In 2023, less than 10% of semaglutide prescriptions were filled through Medicaid for all three brands, with access varying significantly by state, depending on budgetary and political factors. Medicare Part D covered 28.5% and 32.9% of Ozempic and Rybelsus prescriptions, respectively, but only 1.2% for Wegovy, as it generally does not cover obesity medications unless the patient also has a related condition like cardiovascular disease.
The researchers advocate for further studies to investigate how changes in Medicare Part D and Medicaid coverage affect disparities in access to these essential medications. They also suggest that future research should examine individual-level variables such as age, race, ethnicity, and the specific medical conditions—obesity or diabetes—for which the drugs are prescribed.
More information: Christopher Scannell et al, Prescription Fills for Semaglutide Products by Payment Method, JAMA Health Forum. DOI: 10.1001/jamahealthforum.2024.2026
Journal information: JAMA Health Forum Provided by University of Southern California
