Semaglutide Rockets Past Statins as Millions Eligible

About 40% of American adults – about 137 million – are eligible to take the glucagon-like peptide 1 (GLP-1) receptor agonist semaglutide, said the authors of the new study.

Currently, statins are the most commonly prescribed medication among American adults, with about 192 million prescriptions written by 2022, according to one estimate. Research paper writers published online by JAMA Cardiology It is estimated that at least 82 million American adults are eligible for statins.

Semaglutide will soon overtake statins as the most prescribed medication for American adults, the authors said. It was the best-selling drug in the United States by 2023, with sales of nearly $14 billion, making it worth looking at who might qualify, the lead author said. Dhruv S. Kazi, MD, MS, assistant professor. doctorate at Harvard Medical School, Boston.

“We hope to encourage an open public discussion about the number of eligible seniors,” Kazi told. Medscape Medical News.

Kazi said it appears that the United States does not really have what he calls a “game plan” to ensure broad and equal access to expensive, but effective, medicines. “If we can’t treat everybody or treat everybody,” he said, “there has to be something like a risk-based approach where people are at risk.” the development of obesity-related or cardiovascular consequences, death or diabetes is the priority.”

He and his colleagues at Beth Israel Deaconess Medical Center, Boston, Harvard TH Chan School of Public Health, Boston, and Feinberg School of Medicine at Northwestern, Chicago, used data from the National Health and Nutrition Examination Survey from 2015 to 2020 find out how many American adults may be eligible for semaglutide. They focused on diabetes, weight control, and secondary prevention of cardiovascular disease, using inclusion and exclusion criteria from large randomized clinical trials of semaglutide in indications. those.

The authors report that 35 million adults are eligible for semaglutide for diabetes, 129 million for weight management, and 8.9 million for the prevention of second heart disease.

Semaglutide for secondary prevention may be an area of ​​further growth, as there is more insurance coverage for that indication, the authors wrote.

“The numbers are amazing, but not completely surprising,” said Beth Abramson, MD, MSc, Paul Albrechtsen Professor of Cardiac Prevention and Women’s Health in the Division of Cardiology at the University of Toronto, Toronto, Ontario, Canada. “Most of us will have a lot of patients who would qualify for this new procedure,” he said. Medscape Medical News.

The data is a “call to action” because it “makes us think about the issues at hand,” said Abramson, a member of the Prevention Council for the American College of Cardiology.

Although millions of American adults may need these expensive medications, their use may ultimately result in cost savings, said Abramson. Studies have shown that at high doses, semaglutide has reduced cardiovascular events, he said. “Cardiologists need to think about this when seeing their patients and learning about this new class of drugs,” Abramson said.

He also said that semaglutide should be just one piece of the puzzle for patients who need help with weight management. Many patients “need help making the right lifestyle choices,” Abramson said.

Kazi and his allies said that American policymakers and nurses should not ignore the train going down the tracks. “We’re going to have to find prices, we’re going to have to find supply chains,” Kazi said. And, he said, the medical community will have to get over “the stigma of treating overweight and obesity.”

But, he said, even if doctors are comfortable prescribing semaglutide and other GLP-1s, “the cost issue is not over.”

“We will have to have serious discussions as a nation,” said Kazi.

Kazi and his colleagues reported the extracurricular activities in the paper. Co-author Sadiya Khan, MD, is a co-editor of JAMA Cardiology but was not involved in any of the decisions regarding the review of the manuscript or its acceptance. Abramson has reported honoraria from the CPD Network Association, Amgen, AstraZeneca, Bayer, BioSyent, BMS-Pfizer, Boehringer Ingelheim, CHRC, HLS Therapeutics, Novartis, Novo Nordisk, Sanofi, and Servier.

Alicia Ault is a freelance journalist based in Saint Petersburg, Florida, whose work has appeared in publications, including JAMA and Smithsonian.com. You can find her on X @aliciaault.