(B-033) Characteristics of Patients Initiating Wegovy (Semaglutide) for Cardiovascular Risk Reduction in a Medicare Population

Background: Wegovy (semaglutide) was approved for chronic weight management in 2021 and, more recently, was the first glucagon-like peptide-1 (GLP-1) receptor agonist (RA) approved for cardiovascular risk reduction in March 2024. Medicare Part D is prohibited from covering Wegovy for weight-loss but allows coverage for cardiovascular risk reduction. Patients initiating Wegovy for cardiovascular risk reduction have not been well characterized in the Medicare population.

Objectives: Here, we describe clinical characteristics, treatment patterns, and trends of Wegovy initiators in the US Medicare 100% Fee-for-Service (FFS) population.

Methods: Adult (≥18 years) US patients initiating Wegovy from March 01, 2024 onwards were retrospectively identified using the Medicare 100% FFS database, which covers beneficiaries ≥65 and those with disabilities. Patients were required to have ≥6 months of continuous health plan and pharmacy coverage [Part A (Hospital Insurance), Part B (Medical Insurance), and Part D (Prescription Drug Coverage)]. Patient characteristics, baseline clinical and treatment characteristics within 6 months prior to Wegovy initiation (index date) were described. Post-index treatment patterns and utilization trends were assessed.

Results: A total of 4,223 adult patients initiated Wegovy through June 2024 with increasing numbers of patients per month. The median age was 70 years, 60.2% were female, 85.5% were White, and 3.6% were Hispanic. A minority (10.2%) of patients had Type 2 diabetes (T2D), while the majority (80.2%) were overweight/obese prior to initiating Wegovy. More than half (52.1%) had cardiovascular disease (CVD) and nearly 90% were either overweight/obese or had CVD. Patients presented with high proportion of congestive heart failure (24.0%) and peripheral vascular disease (25.2%), 10.1% had myocardial infarction or history of myocardial infarction, and 7.8% had stroke at baseline. The majority of Wegovy prescribers were primary care physicians (52.1%), followed by specialists (25.6%) and nurse practitioners (17.3%).

Conclusions: Consistent with the indication, the majority (~90%) of Medicare FFS patients receiving Wegovy were overweight or obese and/or had cardiovascular disease. Compared to GLP-1 RA users for T2D and obesity in Medicare FFS, Wegovy patients had higher rates of cardiovascular disease. Additional follow-up is needed to better understand characteristics and long-term outcomes of Medicare beneficiaries receiving Wegovy.