Recent pharmacy data revealed a substantial surge in the prescription of glucagon-like peptide-1 (GLP-1) receptor agonists among adolescents and young adults. Between 2020 and 2023, the number of individuals aged 12 to 25 years receiving these prescriptions experienced a remarkable 594.4% increase. This surge contrasts with the overall prescription rate of other pharmacy drugs, which decreased by 3.1% during the same period. Dr. Joyce M. Lee and her colleagues at the University of Michigan Medical School in Ann Arbor highlighted this trend in a research letter published in JAMA. Dr. Lee noted that the rapid rise in dispensing indicated a significant demand for these medications among younger populations.
The study also revealed gender disparities in GLP-1 agonist dispensing among adolescents and young adults. During the study period, girls and young women accounted for the majority of prescription fills. In 2023, 60% of adolescents and 76.4% of young adults dispensed medications were female. Dr. Lee suggested that this disproportionate dispensing may reflect a societal bias towards weight in females.
The GLP-1 receptor agonists analyzed in the study included dulaglutide (Trulicity), exenatide (Byetta, Bydureon), liraglutide (Victoza, Saxenda), semaglutide (Ozempic, Rybelsus, Wegovy), and tirzepatide (Mounjaro, Zepbound). Among these agents, dulaglutide and exenatide are approved for adolescents and adults with type 2 diabetes, while liraglutide and semaglutide have approval for both diabetes and weight management in adult and pediatric patients. Tirzepatide is approved for diabetes and weight management in adults only.
Despite the FDA approval of GLP-1 receptor agonists for weight loss in adolescents in 2022, little is known about the use of these medications in younger patients. Dr. Lee emphasized the importance of gaining more information about the long-term side effects and effectiveness of these medications, especially as they become more commonly used in young patients. She also raised concerns about additional risks for younger individuals of reproductive age.
The analysis revealed significant shifts in prescribing patterns over the study period. While dulaglutide, exenatide, and liraglutide were initially the most commonly prescribed agents for both adolescents and young adults, semaglutide and tirzepatide gained popularity in early 2023. Geographically, nearly half of adolescents and young adults receiving GLP-1 receptor agonists resided in the South. Medicaid was the most common insurance coverage for adolescents, while young adults were primarily covered by commercial insurance.
To ensure safe and appropriate prescribing of GLP-1 receptor agonists, the researchers recommended that efforts include endocrinologists, family medicine physicians, and nurse practitioners. Given the shortage of endocrinologists and obesity medicine specialists, primary care physicians may need more education and training on using these medications. As the use of GLP-1 receptor agonists increases in young patients, it is crucial to focus on the long-term safety and efficacy of these agents, particularly among individuals of reproductive age.
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