Health insurance obstacles are impeding the access of children and adolescents with type 2 diabetes to crucial medications known as GLP-1 receptor agonists (GLP1Ra), reveals a study unveiled at ENDO 2024, the Endocrine Society’s annual conference held in Boston, Massachusetts.
Despite being greenlit by the U.S. Food and Drug Administration (FDA), health insurance providers frequently reject coverage for GLP1Ra drugs, particularly in cases where patients lack a type 2 diabetes diagnosis, researchers have found.
The study, conducted at a prominent children’s hospital, aimed to scrutinize the real-world prescription patterns of GLP1Ra medications, such as liraglutide (sold under the brands Victoza and Saxenda). Examining 599 pediatric patients, averaging 15 years of age, who were prescribed GLP1Ra, the researchers discovered that three-quarters of them grappled with type 2 diabetes, with 58% reliant on public insurance.
Among patients diagnosed with type 2 diabetes, private insurance providers refused coverage for 54% of the prescriptions, while Medicaid declined 27%. For patients without type 2 diabetes, the denial rates were even higher, with private insurers rejecting 55% and Medicaid dismissing 69% of the prescriptions.
The titration process, crucial for patients commencing treatment with liraglutide, involves gradually escalating the dosage until reaching the prescribed level. However, the study unveiled that among children with type 2 diabetes, 33% exceeded the recommended duration to achieve the prescribed dose, and 17% never attained it. Similarly, for patients grappling with obesity, less than half successfully reached their prescribed dose.
Dr. Castano, the lead researcher, emphasized the critical importance of this finding, stating, “This has significant clinical implications since the expected improvements with the use of GLP1Ra in weight or glucose control are likely dose-dependent. If patients are unable to reach the prescribed dose, they will likely not experience the full beneficial effects of the medication.”
While most patients reported experiencing no or mild side effects, the study uncovered two cases of severe pancreatitis among individuals using liraglutide, a previously unreported side effect, Dr. Castano added.
“Our research underscores the formidable hurdles in accessing GLP1Ra medications for patients in need, the challenges patients may encounter in adhering to the recommended titration regimen, and the possibility of additional side effects beyond previous reports,” he concluded.
