Racial and ethnic disparities in GLP-1 prescriptions among veterans with obesity across direct and community care settings.

INTRODUCTION

Obesity is an increasing chronic medical condition facing the veteran population. Glucagon-like peptide 1 receptor agonists (GLP-1s) have emerged as an optimal treatment for obesity- and related-medical disorders. As the Veterans Health Administration (VHA) continues to expand community-based care purchased under the MISSION Act, it is unknown whether veterans receiving community-based primary care experience comparable access to GLP-1 prescriptions.

METHODS

In this national analysis of VHA data, we assessed differences in GLP-1 prescribing among veterans with overweight or obesity in VHA direct care compared with community care.

RESULTS

Veterans with 3 or more primary care visits receiving VHA-direct primary care had 1.2 percentage points (pp) higher adjusted probability of GLP-1 prescriptions (20% higher odds) than veterans receiving mostly community primary care. Black and Asian veterans had 1.8-pp and 2.2-pp lower probabilities of GLP-1 prescriptions (26% and 34% lower odds, respectively) compared with White counterparts across both settings.

CONCLUSION

Researchers and policymakers should continue to monitor whether differences in care between the direct and community settings contribute to disparities in GLP-1 access.