Abstract 50: Factors Associated With Obesity Pharmacotherapy Prescription Among Ambulatory Patients With Excess Weight

Background: Semaglutide, liraglutide (GLP1-RA), and tirzepatide (GLP1/GIP-RA) are potent anti-obesity pharmacotherapies resulting in marked weight loss and improved cardiometabolic outcomes. Limited insurance coverage is a well-understood barrier to these new therapies; thus, we sought to characterize additional clinical and sociodemographic factors associated with the prescription of these medications. Hypothesis: Likelihood of prescription of novel anti-obesity medications will be lower for individuals within racial and ethnic minority and lower SES subgroups. Methods: We identified adults who have obesity (BMI ≥30), existing insurance coverage for anti-obesity medications, and received outpatient care at Johns Hopkins from January 2023 to September 2023. We used multivariable logistic regression to evaluate factors associated with prescription of anti-obesity pharmacotherapies. Results: We included 18,164 patients (mean age 51 years, 64% female, 54% White, 35% Black, 5% Asian, mean BMI 36 kg/m 2 ). About 3% of eligible adults were prescribed anti-obesity medications. The likelihood of prescription was lower among Black adults (OR: 0.76, 95%CI [0.61-0.96]), males (OR: 0.54 [0.42-0.68]), and adults younger and older than 40-50 years of age; and higher for those with higher BMI (per 1-unit higher BMI, OR: 1.06 [1.05-1.07]). Living in a neighborhood with a higher area deprivation index or lower income was not independently associated with the likelihood of prescription. Clinically, those with diabetes (OR: 3.52 [2.78-4.44]) and hypertension (OR: 1.36 [1.08-1.71]) were more likely to be prescribed novel obesity pharmacotherapies. Conclusion: Among those with existing insurance coverage, the likelihood of obesity pharmacotherapy prescription differs by sociodemographic factors and cardiometabolic comorbidities. Understanding the mechanisms of these differences may have key implications for obesity management in diverse populations, and ultimately for cardiometabolic health equity.