A recent study revealed that over half of all US Adults in the United States may be eligible for semaglutide therapy. This medication, primarily used for diabetes management, is also prescribed for weight loss and cardiovascular disease prevention. Researchers analyzed the eligibility of US Adults based on three main criteria: diabetes status, weight management, and cardiovascular disease prevention.
The findings, which rely on demographic and clinical data, provide valuable insight into the potential demand for this costly yet highly effective medication. The results could play a critical role in shaping future healthcare policies and pharmaceutical budgets.
Background
Semaglutide, approved by the U.S. Food and Drug Administration (FDA), is widely recognized for its effectiveness in managing type 2 diabetes, aiding weight loss, and reducing cardiovascular risks. It works as a glucagon-like peptide-1 receptor agonist, which helps regulate blood sugar levels, stimulates insulin release, and supports weight control.
Initially prescribed to manage diabetes, semaglutide has gained popularity for its additional benefits. Its growing demand has made it one of the best-selling drugs in the United States. However, with its increasing use comes significant healthcare costs, particularly for patients whose insurance plans may not cover the medication’s broader indications.
Understanding the demographics of eligible individuals is crucial for policymakers to effectively manage costs and ensure equitable access to the therapy.
Study Overview
The study analyzed data from the National Health and Nutrition Examination Survey (NHANES) conducted between 2015 and 2020. This large, cross-sectional survey gathers health information from non-institutionalized U.S. adults through interviews, physical exams, and laboratory tests.
Eligibility for semaglutide therapy was determined based on three criteria:
1. Diabetes Management
A diabetes diagnosis, a hemoglobin A1c (HbA1c) level of at least 7.0%, or current use of diabetes therapies. Around 35 million adults qualified based on diabetes-related criteria.
2. Weight Management
A body mass index (BMI) of 30 or higher, or a BMI of 27 or above with conditions such as hypertension, high cholesterol, or a history of cardiovascular events. Approximately 129.2 million adults met the weight-related criteria, including those with a BMI of 30 or more or a BMI of 27 with associated health conditions.
3. Cardiovascular Disease Prevention
Adults aged 45 and older with a BMI of 27 or more and a history of major cardiovascular events like stroke or myocardial infarction. About 8.9 million adults aged 45 and older qualified due to high BMI and a history of cardiovascular events.
Patients with end-stage kidney disease on dialysis and those who had undergone weight-loss surgery were excluded. The findings were scaled to reflect the 2020 U.S. adult population.
Key Findings
The analysis revealed that approximately 136.8 million adults in the United States, or over half the US Adults population, are eligible for semaglutide therapy.
The study also highlighted demographic variations. The average age of eligible individuals was 50.7 years, with about half identifying as female. Insurance coverage varied significantly, with 26.8 million individuals insured through Medicare, 13.8 million through Medicaid, and 61.1 million covered by private insurance.
Additionally, approximately 39.3 million adults qualified for semaglutide under either diabetes or cardiovascular prevention criteria but did not meet weight management criteria. This subgroup included 13 million Medicare recipients and 4.7 million Medicaid recipients.
Implications
The study underscores the widespread eligibility for semaglutide therapy among U.S. adults and the associated healthcare costs. With over half of the US Adults population meeting the criteria for treatment, managing the financial implications of semaglutide use becomes a critical challenge.
The insights gained from this research can guide policymakers in designing strategies to address coverage gaps while ensuring that expanding access to semaglutide remains cost-effective. As the demand for this medication continues to grow, balancing accessibility and affordability will be essential to meeting the needs of millions of eligible patients.
