(C-076) Trends in Postpartum Anti-Obesity Medication Use among Commercially Insured Pregnant Women, 2016-2022

Background: Weight loss before pregnancy is recommended to reduce the risks associated with obesity during pregnancy. Anti-obesity medications (AOMs) are an increasingly common treatment option for healthy weight loss before pregnancy; however, their uptake and reinitiation of AOMs in the postpartum period are not well understood.

Objectives: We sought to assess AOM utilization patterns, including use of glucagon-like peptide-1 agonists (GLP-1), in the postpartum period among those with and without prior use of AOMs before delivery.

Methods: We identified a retrospective cohort of reproductive aged women (12-55 years) with evidence of live birth using Merative® MarketScan Commercial Claims data. We used a previously validated claims-based algorithm to identify pregnant individuals between 2016 and 2022. Further, we required continuous enrollment with pharmacy benefits from 12 months before through 6 months after delivery. For each patient, we identified filled prescriptions for commonly used AOMs and GLP-1s during the study period. We examined trends in AOM and GLP-1 use, and the proportion of days covered in the postpartum period, stratifying by prior AOM use and non-GLP-1 AOMs versus GLP-1s.

Results: Our study included 625,575 pregnancies comprising 566,622 unique individuals with an average age of 31.2 (SD: 5.3). In the 6 months after delivery, 9,492 patients filled an AOM prescription, of whom 900 (9.5%) individuals received a GLP-1 medication. Among the 2,438 patients with no prior history of AOM use, the average time to first postpartum AOM prescription was 63.9 days (SD: 52.8). Among the 25,164 individuals who had filled an AOM in the year before delivery, only 7,054 (28.0%) restarted treatment within 6 months postpartum, but they had a significantly lower mean time to reinitiation of 53.3 days (SD: 47.4, p < 0.01). New users of AOMs postpartum had an average of 38.9% (SD: 27.5%) of days covered by a medication in the 6 months after delivery, while patients with a prior history of filling AOMs had a higher proportion of 63.5% (SD: 37.6%, p< 0.01) days covered. Individuals filling GLP-1 medications postpartum had 70.3% (SD: 52.3%) of days covered and those receiving other AOMs had a lower proportion of 58.1% (SD: 37.2%, p< 0.01) covered.

Conclusions: Patients with a prior history of AOM utilization had a faster time to treatment reinitiation than new AOM users . Less than 10% of individuals filling AOM medications postpartum received a GLP-1, but these patients had the highest proportion of days covered in the 6 months after their delivery.