Real‐world use and effectiveness of tirzepatide among individuals without type 2 diabetes: Results from the Optum Market Clarity database
Emily R. Hankosky, Chanadda Chinthammit, Alexandra Meeks, Ahong Huang, Jennifer M. Ward, Donna Mojdami, Theresa Hunter
Abstract
Abstract Aims To understand real‐world tirzepatide utilization and effectiveness (change in weight and body mass index [BMI]) among people without type 2 diabetes (T2D) in the United States. Materials and Methods This retrospective, observational study used Optum's de‐identified Market Clarity database (index date: first‐observed tirzepatide claim; index period: 13 May 2022–30 September 2023). Outcomes were assessed in 3 cohorts: (1) Overall cohort: age ≥18 years; ≥1 tirzepatide claim; no baseline T2D diagnosis codes, anti‐diabetes medication use (except metformin) or glycated haemoglobin ≥6.5%; continuous medical and pharmacy enrolment for ≥12 months pre‐index. (2) Utilization cohort: all above criteria and anti‐obesity medication (AOM)‐eligible individuals (BMI ≥30 kg/m 2 , or ≥27 kg/m 2 with ≥1 obesity‐related complication [ORC]) for assessment of tirzepatide utilization (persistence, discontinuation, dose escalation and switching 6 months post‐index). (3) Effectiveness cohort: all above criteria and AOM‐eligible glucagon‐like peptide‐1 receptor agonist (GLP‐1 RA)‐naive individuals persistent on tirzepatide for ≥6 months with pre‐ and post‐index weight and BMI measurements for assessment of tirzepatide effectiveness (mean absolute and percent bodyweight/BMI change from baseline and bodyweight/BMI reduction ≥5%, ≥10%, ≥15% and ≥20%). All analyses were descriptive. Results Overall cohort included 20,998 individuals (mean age: 47.4 years, female: 74.9%, mean BMI: 36.9 kg/m 2 ). At index, 66.0% of individuals had ≥1 ORC, while 44.4% had ≥2 ORCs. Persistence in the utilization cohort was 55.4%; 30.8% switched to a different AOM/GLP‐1 RA analogue or restarted tirzepatide after discontinuation, and by the sixth prescription fill, 74.2% were on <10 mg tirzepatide. Mean weight reduction in the effectiveness cohort was 11.9% at 6 months post‐index (≥5%: 85.8%; ≥10%: 61.5%). Conclusions Real‐world evidence suggests multimorbidity is common among tirzepatide initiators. While tirzepatide dose escalation was slower than in clinical trials, individuals achieved weight reduction at 6 months, consistent with clinical trials.