Low Adoption of Weight Loss Medications: A Comparison of Prescribing Patterns of Antiobesity Pharmacotherapies and SGLT2s

Overview

Journal Obesity (Silver Spring)

Specialties Endocrinology
Nutritional Sciences
Physiology

Date 2016 Aug 30

PMID 27569120

Citations 52

Authors

Catherine E Thomas

Elizabeth A Mauer

Alpana P Shukla

Samrat Rathi

Louis J Aronne

Affiliations

Soon will be listed here.

Abstract

Objective: To characterize the adoption of antiobesity pharmacotherapies, as compared with that of the newest antidiabetes pharmacotherapy, subtype 2 sodium-glucose transport protein inhibitors (SGLT2s), among prescribers in the United States.

Methods: A retrospective analysis of 2012 to 2015 data extracted from the IMS Health National Prescription Audit™ and Xponent™ assessed adoption rates of antiobesity pharmacotherapies and SGLT2s.

Results: The number of dispensed antidiabetes prescriptions was 15 times the number of dispensed antiobesity prescriptions. The antiobesity market share was: 74.0% phentermine, 18.6% new antiobesity pharmacotherapies. The mean increase in prescriptions/month were: 25,259 for SGLT2s, 5,154 for new antiobesity pharmacotherapies, and 2,718 for phentermine. Medical specialties prescribing the majority of the analysis medications were Family Medicine/General Practice and Internal Medicine. Endocrinology had the highest prevalence of prescribers of any subspecialty.

Conclusions: The adoption rate of SGLT2s was nearly exponential, while the adoption rate of new antiobesity pharmacotherapies was linear. Considering the relative prevalence of obesity to diabetes and that obesity is a major cause of diabetes, these results are paradoxical and suggest systematic barriers against the prescribing of antiobesity pharmacotherapies. The under-prescribing of antiobesity pharmacotherapies is widely acknowledged, but this is the first prescription data of these new medications to demonstrate its extent in the United States.

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References

Roden M, Weng J, Eilbracht J, Delafont B, Kim G, Woerle H . Empagliflozin monotherapy with sitagliptin as an active comparator in patients with type 2 diabetes: a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Diabetes Endocrinol. 2014; 1(3):208-19. DOI: 10.1016/S2213-8587(13)70084-6. View

Stenlof K, Cefalu W, Kim K, Alba M, Usiskin K, Tong C . Efficacy and safety of canagliflozin monotherapy in subjects with type 2 diabetes mellitus inadequately controlled with diet and exercise. Diabetes Obes Metab. 2013; 15(4):372-82. PMC: 3593184. DOI: 10.1111/dom.12054. View

Hendricks E, Rothman R, Greenway F . How physician obesity specialists use drugs to treat obesity. Obesity (Silver Spring). 2009; 17(9):1730-5. DOI: 10.1038/oby.2009.69. View

Ferrannini E, Ramos S, Salsali A, Tang W, List J . Dapagliflozin monotherapy in type 2 diabetic patients with inadequate glycemic control by diet and exercise: a randomized, double-blind, placebo-controlled, phase 3 trial. Diabetes Care. 2010; 33(10):2217-24. PMC: 2945163. DOI: 10.2337/dc10-0612. View

Block J, Choudhry N, Carpenter D, Fischer M, Brennan T, Tong A . Time series analyses of the effect of FDA communications on use of prescription weight loss medications. Obesity (Silver Spring). 2013; 22(3):943-9. DOI: 10.1002/oby.20596. View

Magkos F, Fraterrigo G, Yoshino J, Luecking C, Kirbach K, Kelly S . Effects of Moderate and Subsequent Progressive Weight Loss on Metabolic Function and Adipose Tissue Biology in Humans with Obesity. Cell Metab. 2016; 23(4):591-601. PMC: 4833627. DOI: 10.1016/j.cmet.2016.02.005. View

Apovian C, Aronne L, Rubino D, Still C, Wyatt H, Burns C . A randomized, phase 3 trial of naltrexone SR/bupropion SR on weight and obesity-related risk factors (COR-II). Obesity (Silver Spring). 2013; 21(5):935-43. PMC: 3739931. DOI: 10.1002/oby.20309. View

Wing R, Lang W, Wadden T, Safford M, Knowler W, Bertoni A . Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes. Diabetes Care. 2011; 34(7):1481-6. PMC: 3120182. DOI: 10.2337/dc10-2415. View

Nicklas J, Huskey K, Davis R, Wee C . Successful weight loss among obese U.S. adults. Am J Prev Med. 2012; 42(5):481-5. PMC: 3339766. DOI: 10.1016/j.amepre.2012.01.005. View

10.

Garber A, Abrahamson M, Barzilay J, Blonde L, Bloomgarden Z, Bush M . AACE comprehensive diabetes management algorithm 2013. Endocr Pract. 2013; 19(2):327-36. DOI: 10.4158/endp.19.2.a38267720403k242. View

11.

Apovian C, Aronne L, Bessesen D, McDonnell M, Murad M, Pagotto U . Pharmacological management of obesity: an endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2015; 100(2):342-62. DOI: 10.1210/jc.2014-3415. View

12.

Aronne L, Wadden T, Peterson C, Winslow D, Odeh S, Gadde K . Evaluation of phentermine and topiramate versus phentermine/topiramate extended-release in obese adults. Obesity (Silver Spring). 2013; 21(11):2163-71. DOI: 10.1002/oby.20584. View

13.

Kushner R . Tackling obesity: is primary care up to the challenge?. Arch Intern Med. 2010; 170(2):121-3. DOI: 10.1001/archinternmed.2009.479. View

14.

Snow V, Barry P, Fitterman N, Qaseem A, Weiss K . Pharmacologic and surgical management of obesity in primary care: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2005; 142(7):525-31. DOI: 10.7326/0003-4819-142-7-200504050-00011. View

15.

Gadde K, Allison D, Ryan D, Peterson C, Troupin B, Schwiers M . Effects of low-dose, controlled-release, phentermine plus topiramate combination on weight and associated comorbidities in overweight and obese adults (CONQUER): a randomised, placebo-controlled, phase 3 trial. Lancet. 2011; 377(9774):1341-52. DOI: 10.1016/S0140-6736(11)60205-5. View

16.

Aronne L, Shanahan W, Fain R, Glicklich A, Soliman W, Li Y . Safety and efficacy of lorcaserin: a combined analysis of the BLOOM and BLOSSOM trials. Postgrad Med. 2014; 126(6):7-18. DOI: 10.3810/pgm.2014.10.2817. View

17.

Ryan D, Heaner M . Guidelines (2013) for managing overweight and obesity in adults. Preface to the full report. Obesity (Silver Spring). 2014; 22 Suppl 2:S1-3. DOI: 10.1002/oby.20819. View

18.

Ogden C, Carroll M, Kit B, Flegal K . Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA. 2014; 311(8):806-14. PMC: 4770258. DOI: 10.1001/jama.2014.732. View

19.

Xia Y, Kelton C, Guo J, Bian B, Heaton P . Treatment of obesity: Pharmacotherapy trends in the United States from 1999 to 2010. Obesity (Silver Spring). 2015; 23(8):1721-8. DOI: 10.1002/oby.21136. View

20.

Garvey W, Ryan D, Look M, Gadde K, Allison D, Peterson C . Two-year sustained weight loss and metabolic benefits with controlled-release phentermine/topiramate in obese and overweight adults (SEQUEL): a randomized, placebo-controlled, phase 3 extension study. Am J Clin Nutr. 2011; 95(2):297-308. PMC: 3260065. DOI: 10.3945/ajcn.111.024927. View