Drug Utilization Research / Trends and comparisons

2D-10 - Group‑based trajectory modeling to identify adherence patterns of Mississippi Medicaid Members Initiating GLP-1 Receptor Agonists for Obesity Management

Sunday, August 24, 2025

4:35 PM - 4:40 PM ET

Presenting Author(s)

SB

Shadi Bazzazzadehgan

Department of Pharmacy Administration, School of Pharmacy, University of Mississippi, University, MS, USA, United States

Co-Author(s)

Liang-Yuan Lin

Department of Pharmacy Administration, School of Pharmacy, University of Mississippi, University, MS, USA, United States
OG

Omkar Ghodke

Department of Pharmacy Administration, School of Pharmacy, University of Mississippi, University, MS, USA, United States
DS

Dennis Smith

Mississippi Division of Medicaid, Jackson, MS, USA, United States
TK

Terri Kirby

Mississippi Division of Medicaid, Jackson, MS, USA, United States
EP

Eric Pittman

Department of Pharmacy Administration and Center for Pharmaceutical Marketing & Management, School of Pharmacy, University of Mississippi, University, MS, USA, United States
KB

Kaustuv Bhattacharya

Department of Pharmacy Administration and Center for Pharmaceutical Marketing & Management, School of Pharmacy, University of Mississippi, University, MS, USA, United States

Background: As of July 2023, semaglutide (Wegovy®) and liraglutide (Saxenda®), both GLP-1 receptor agonists (GLP-1RAs), were included in the Mississippi Medicaid preferred drug list as anti-obesity medications (AOMs). While these medications have been shown to be clinically effective, there is sparse data related to real-world adherence to these medications.

Objectives: This study aimed to analyze the adherence trajectories of GLP-1RA-AOMs among Mississippi Medicaid members and identify the sociodemographic and clinical factors associated with each adherence trajectory.

Methods: This retrospective study utilized Mississippi Medicaid administrative claims data from 2023-2024. The study population consisted of individuals who newly initiated GLP-1RA-AOMs between July 2023 and June 2024 and had continuous enrollment for six months prior to initiation (baseline period) and six months post-initiation (follow-up period). Adherence patterns were assessed by calculating the monthly proportion of days covered (PDC) during the follow-up period post-initiation. A group-based trajectory model was used to categorize individuals based on distinct adherence trends. Sociodemographic and clinical predictors from the baseline period were examined using a multinomial logistic regression model, with the consistent adherent group serving as the reference category.

Results: The study cohort included 1,601 Mississippi Medicaid members who initiated GLP-1RAs-AOMs, the majority of whom were women (89.01%) and Black (47.28%). Four distinct adherence trajectories were identified: consistent adherent (59.2%), gradual decliners (16.7%), rapid discontinuers (15.3%), and fluctuating adherers (8.8%). Relative to the consistent adherent group, enrollment in Coordinated Care Organization programs was significantly associated with lower odds of belonging to other adherence groups (gradual decliners: odds ratio [OR] = 0.53, 95% confidence interval [CI] = 0.36–0.80; rapid discontinuers: OR = 0.48, 95% CI = 0.32–0.71; and fluctuating adherers: OR = 0.44, 95% CI = 0.27–0.71). Additionally, older age (>45 years; OR = 0.62, 95% CI = 0.44–0.87) and sleep apnea (OR = 0.57, 95% CI = 0.37–0.86) were associated with a decreased likelihood of belonging to the gradual decliner group, relative to the consistent adherent group.

Conclusions: The identified predictors offer valuable insights into suboptimal adherence to GLP-1RA-AOMs among Mississippi Medicaid members. These findings can inform targeted interventions aimed at improving adherence within this population. Future research should examine the relationship between adherence to GLP-1RA-AOMs and patient outcomes.