Characteristics and Treatment Patterns of People Without Type 2 Diabetes Diagnoses Who Use Tirzepatide in the United States.

PURPOSE: The purpose of this study was to understand real-world use of Tirzepatide among people without type 2 diabetes (T2D) diagnoses in the United States in the Merative MarketScan® Commercial (MarketScan) and Optum Clinformatics Claims (CDM) databases. METHODS: This retrospective, observational, descriptive study used data from the MarketScan and Optum CDM databases (index date: first-observed Tirzepatide claim) from May 2021 to September 2023. Key eligibility criteria included age ≥18 years, ≥1 Tirzepatide claim, no baseline T2D diagnosis codes or antihyperglycemic medication use (except metformin), and continuous medical and pharmacy enrollment for ≥12 months pre-index. Demographic characteristics were assessed at the index date, while clinical characteristics and treatment-related data were identified during the 12-month pre-index period. Tirzepatide persistence and utilization (6 months post index) were assessed for individuals with ≥6 months of follow-up after initiation of Tirzepatide treatment (index date). Data were analyzed separately for each database. FINDINGS: Overall, 15,534 eligible adults were identified in the MarketScan database and 6800 in the Optum CDM database; mean age was 46.2 years and 55.9 years, respectively, and in both databases, >70% were female. A total of 70.6% (MarketScan) and 81.0% (Optum CDM) of individuals had at least one obesity-related complication, with the most prevalent being hypertension, dyslipidemia, and pre-diabetes. There were 8709 individuals in the MarketScan database and 3384 in the Optum CDM database with ≥6 months of follow-up. In both databases, approximately two-thirds of people were started on 2.5 mg and, by the sixth prescription fill, the most common doses of Tirzepatide were 5 mg and 7.5 mg. Tirzepatide persistence ranged from 60.6% to 75.7% across both databases, with an allowed gap between prescriptions of 45 days or 60 days. Of individuals who discontinued tirzepatide, 10.2-19.5% restarted Tirzepatide during the 6-month follow-up. IMPLICATIONS: In both databases, most people initiating Tirzepatide without T2D diagnoses had ≥1 obesity-related complication, indicating that Tirzepatide is being used in people with multimorbidity. A high proportion of people who initiated Tirzepatide were persistent on treatment at 6 months, which is higher than that previously reported for glucagon-like peptide-1 receptor agonists.