A research letter found that 136.8 million U.S. adults met eligibility criteria for semaglutide therapy across its approved indications, based on analysis of national health survey data.
In the study, published in JAMA Cardiology, investigators from Beth Israel Deaconess Medical Center and Harvard Medical School analyzed National Health and Nutrition Examination Survey data from 2015 to March 2020.
The analysis revealed that among eligible adults, 35.0 million qualified for diabetes management, while 129.2 million met criteria for weight management. An additional 8.9 million qualified for secondary prevention of cardiovascular disease (CVD).
The investigators identified that 39.3 million adults met criteria for either diabetes management or secondary CVD prevention. Among the adults in this subgroup, 13.0 million had Medicare insurance and 4.7 million had Medicaid coverage.
Insurance coverage analysis of the total eligible population showed 26.8 million Medicare beneficiaries, 13.8 million Medicaid beneficiaries, and 61.1 million privately insured individuals. The mean age of eligible individuals was 50.7 years, with women comprising 49.1% of the population.
The research team analyzed data from 25,531 survey participants, establishing distinct eligibility pathways. Diabetes management criteria included either a self-reported diabetes diagnosis, hemoglobin A1C levels of 7.0% or higher, or current use of diabetes therapies. Weight management criteria encompassed individuals with a body mass index (BMI) of 30 or greater as well as those with a BMI of 27 or greater who had weight-related comorbidities.
Clinical characteristics of eligible individuals included a mean BMI of 33.0, with 64.7% having hypertension and 67.4% having hyperlipidemia. Diabetes affected 26.7% of the eligible population, while 5.1% had a history of coronary heart disease.
The researchers noted that 4.3 million individuals who have CVD but not diabetes might gain coverage based on the secondary prevention indication. They identified limitations in their analysis, including difficulty accurately identifying some rare contraindications to semaglutide therapy as a result of data availability constraints.
The findings were presented at the American Heart Association Scientific Sessions 2024 in Chicago and conflict of interest disclosures can be found in the study.