Sociodemographic disparities in semaglutide and tirzepatide prescription for obesity treatment.

INTRODUCTION

Semaglutide and tirzepatide, the 2 most recently approved glucagon-like peptide-1 receptor agonists, have demonstrated substantial effectiveness in weight management. However, evidence on treatment inequities remains limited. This study assesses temporal trends and sociodemographic disparities in semaglutide and tirzepatide prescription.

METHODS

Using claims data from Komodo Health, we identified commercially insured individuals aged 18-64 years with overweight or obesity but without type 2 diabetes. We estimated 6-month cumulative incidence of semaglutide and tirzepatide prescription across sociodemographic groups and examined disparities by health care provider socioeconomic status.

RESULTS

Six-month cumulative incidence of prescription increased from 1.9% to 16.6% over the study period. Higher access was associated with being female, non-Hispanic White, in higher body mass index categories, and seen at a higher socioeconomic status (SES)-quartile provider. Uptake was significantly lower in lower provider neighborhood SES groups (lowest quartile adjusted odds ratio: 0.75; 95% CI: 0.73-0.78, compared with the highest quartile), and the differences widened over time. The SES disparities were more pronounced at lower BMI categories.

CONCLUSION

Prescription of semaglutide and tirzepatide increased rapidly from 2021 to 2025. Sociodemographic disparities widened over time. Policies addressing provider-level resourcing and pharmaco-equity in drug benefit design are needed to prevent these therapies from exacerbating existing health disparities.