Sociodemographic Disparities in Semaglutide and Tirzepatide Prescription for Obesity Treatment

Abstract Introduction Semaglutide and tirzepatide, two most recently approved glucagon-like peptide-1 receptor agonists, have demonstrated substantial effectiveness in weight management. However, evidence on treatment inequities remained limited. This study assesses temporal trends and sociodemographic disparities in semaglutide and tirzepatide prescription. Methods Using claims data from Komodo Health, we identified commercially insured individuals aged 18-64 with overweight or obesity but without type 2 diabetes. We estimated 6-month cumulative incidence of semaglutide and tirzepatide prescription across sociodemographic groups and examined disparities by healthcare provider socioeconomic status. Results Six-month cumulative incidence of prescription rose from 1.9% to 16.6% over the study period. Higher access was associated with being women, non-Hispanic White, in higher BMI categories, and seen at higher-SES-quartile provider. Uptake was significantly lower in lower provider neighborhood SES groups (lowest quartile aOR, 0.75; 95% CI 0.73-0.78 compared to highest quartile), and the differences widened over time. SES disparities were more pronounced at lower BMI categories. Conclusion Prescription of semaglutide and tirzepatide increased rapidly from 2021 to 2025. Sociodemographic disparities widened over time. Policies addressing provider-level resourcing, and pharmacoequity in drug benefit design are needed to prevent these therapies from exacerbating existing health disparities.