Characteristics and Treatment Patterns of People Without Type 2 Diabetes Diagnoses Who Use Tirzepatide in the United States

Purpose

The purpose of this study was to understand real-world use of Tirzepatide among people without type 2 diabetes (T2D) diagnoses in the United States in the Merative^TM MarketScan® Commercial (MarketScan) and Optum Clinformatics Claims (CDM) databases.

Methods

This retrospective, observational, descriptive study used data from the MarketScan and Optum CDM databases (index date: first-observed Tirzepatide claim) from May 2021 to September 2023. Key eligibility criteria included age ≥18 years, ≥1 Tirzepatide claim, no baseline T2D diagnosis codes or antihyperglycemic medication use (except metformin), and continuous medical and pharmacy enrollment for ≥12 months pre-index. Demographic characteristics were assessed at the index date, while clinical characteristics and treatment-related data were identified during the 12-month pre-index period. Tirzepatide persistence and utilization (6 months post index) were assessed for individuals with ≥6 months of follow-up after initiation of Tirzepatide treatment (index date). Data were analyzed separately for each database.

Findings

Overall, 15,534 eligible adults were identified in the MarketScan database and 6800 in the Optum CDM database; mean age was 46.2 years and 55.9 years, respectively, and in both databases, >70% were female. A total of 70.6% (MarketScan) and 81.0% (Optum CDM) of individuals had at least one obesity-related complication, with the most prevalent being hypertension, dyslipidemia, and pre-diabetes. There were 8709 individuals in the MarketScan database and 3384 in the Optum CDM database with ≥6 months of follow-up. In both databases, approximately two-thirds of people were started on 2.5 mg and, by the sixth prescription fill, the most common doses of Tirzepatide were 5 mg and 7.5 mg. Tirzepatide persistence ranged from 60.6% to 75.7% across both databases, with an allowed gap between prescriptions of 45 days or 60 days. Of individuals who discontinued tirzepatide, 10.2–19.5% restarted Tirzepatide during the 6-month follow-up.

Implications

In both databases, most people initiating Tirzepatide without T2D diagnoses had ≥1 obesity-related complication, indicating that Tirzepatide is being used in people with multimorbidity. A high proportion of people who initiated Tirzepatide were persistent on treatment at 6 months, which is higher than that previously reported for glucagon-like peptide-1 receptor agonists.