773-P: Trends in Obesity Drug Initiation after the Approval of Tirzepatide in Adults without Type 2 Diabetes

Introduction & Objective: Tirzepatide was approved for the treatment of type 2 diabetes (T2D) (May 2022) and more recently for obesity (November 2023). However, tirzepatide has been used off-label for the treatment of obesity in adults without T2D prior to November 2023. The utilization trends and uptake among adults without T2D is unknown. Methods: Using a US commercial claims database, we identified adults without T2D who initiated anti-obesity drugs between 1/2021 and 6/2023 and 1) plotted monthly drug initiation trends before and after tirzepatide approval for T2D (May 2022), and 2) compared the uptake of tirzepatide to the historical uptake of other GLP-1RA during their first 13 months after FDA approval. Results: From 1/2021 to 6/2023, semaglutide initiation decreased (from 26.9% to 23.5%), whereas tirzepatide use increased dramatically (from 0.3% to 45.4%) (Figure A). Compared with the uptake of other GLP-1RA drugs among patients without T2D during their first 13 months after FDA approval, the uptake of tirzepatide was steep and sustained (Figure B). All other medications were initiated less frequently, with liraglutide and phentermine experiencing notable declines after the approval of tirzepatide. Conclusion: Off-label use of tirzepatide increased sharply among adults without T2D during its first 13 months on the market, even though it was not approved for the treatment of obesity until November 2023.