An Oct. 13 analysis from the Health Transformation Alliance examined linked claims and EHR data for 12.7 million patients from 2018 through 2025 to identify who is most and least likely to respond to GLP-1 therapy.
Here are six things to know:
- Researchers used EHR data and linked claims data, comparing outcomes across medications and against similar patients on non-GLP-1 treatments. They then built predictive models to identify the traits of the most and least likely responders.
- Among patients with Type 2 diabetes, the most effective group saw HbA1c fall 2.6 percentage points and lost 8.4% of body weight on average, and 94% stayed on therapy for at least nine months. These patients tended to have an HbA1c above 8% before treatment, lower overall illness severity and no emergency department visits or inpatient admissions in the prior six months.
- The least effective diabetes group saw HbA1c rise 0.1 percentage points and gained 2.7% of body weight on average, and 83% stayed on therapy for at least nine months. These patients tended to have higher illness severity and at least one emergency department visit or inpatient admission in the prior six months.
- Among patients with obesity but not diabetes, the most effective group lost 9.4% of body weight on average, and 84.5% lost at least 5%. These patients were more likely to be 44 or older, weigh 175 to 299 pounds, have no sleep disorder and have fewer than three prescription fills for obesity-related conditions at baseline. Eighty percent stayed on therapy for at least nine months.
- The less effective obesity group lost 5.3% on average, and 64.4% lost at least 5%. They tended to weigh less than 175 pounds or at least 300 pounds and to be younger, for example under 40. Seventy-six percent stayed on therapy for at least nine months.
- The authors said the study is not intended to predict individual outcomes or establish coverage criteria. It was observational, did not evaluate workforce outcomes such as productivity, absenteeism, disability or retention, and most results reflect about a year of follow-up, so long-term return on investment remains uncertain.
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