What's Prescribed More Often: Weight-Loss Meds or Diabetes Drugs?

Pharmacists are much more likely to see prescriptions for sodium-glucose co-transporter 2 (SGLT2) inhibitors than obesity medications, recent prescription data reveal.

Researchers behind the results published in Obesity noted that these were curious findings, since obesity is more widespread and a risk factor for developing diabetes.

“Given the close tie between obesity and type 2 diabetes, treating obesity should be an obvious first step for health care providers to prevent and treat diabetes,” said lead researcher Catherine E. Thomas in a press release. “By treating obesity, we may be able to decrease the number of patients with type 2 diabetes, among other related diseases and the medications used to treat them.”

The researchers’ aim was to compare the prescribing rates for the 2 pharmacotherapies in the United States. To do so, they extracted data from the IMS Health National Prescription Audit and Xponent from 2012 to 2015.

Their findings suggest that pharmacists dispense prescription diabetes medications 15 times more often than they dispense weight-loss drugs. Nearly three-quarters of the patients that the researchers studied took phentermine, while around 18% took obesity medications. The mean increase in prescriptions per month was around 25,000 for SGLT2s, around 5100 for new obesity medications, and around 2700 for phentermine.

“The adoption rate of SGLT2s was nearly exponential, while the adoption rate of new antiobesity pharmacotherapies was linear,” they concluded.

Prescribers were most often in family medicine/general practice and internal medicine, and of all the subspecialties, endocrinology had the highest prevalence of prescribers, according to the researchers.

They suggested that there may be at least 4 barriers that hinder obesity medication prescribing:

1. Reimbursement issues

2. Time constraints during office visits

3. Lack of training about weight-loss medications

4. Other competing concerns/demands

This was the first study to use prescription data to support the idea that obesity pharmacotherapies are underprescribed.

“A greater urgency in the treatment of obesity—on the part of clinicians and patients—is essential,” Thomas concluded. “We're talking about prolonged and better quality of life for patients.”

More than two-thirds of adults are overweight or obese, and many organizations, such as the National Cancer Institute, estimate that the number of obese adults will likely continue to grow to more than 40% by 2030.

Seena Haines, PharmD, FAPhA, BCACP, BC-ADM, CDE, professor and associate dean for faculty at Palm Beach Atlantic University Gregory School of Pharmacy, told Pharmacy Times that health care providers should check in with patients on a monthly basis for the first 3 months that they’re on a weight-loss medication. Pharmacists should also be sure to emphasize to patients that pharmacotherapy doesn’t replace lifestyle modifications, she said.

Research suggests that individual or group follow ups at least 1 or 2 times per month is more effective than the patient being on his or her own with no check-ins. Drug packet inserts have shown that liraglutide, orlistat, naltrexone/buproprion, phentermine/topiramate, and lorcaserin are the most effective at achieving a 5% body weight loss after 1 year.