Current Utilization Patterns of Glucagon-Like Peptide-1 Receptor Agonists
Why this work is in the frame
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Bibliographic record
Abstract
The real-world use of glucagon-like peptide-1 (GLP-1) receptor agonists (RAs), which are funded for type 2 diabetes mellitus (T2DM) across public drug plans in Canada, was analyzed to determine their current utilization patterns and estimate their suspected use outside of T2DM. Drug plan expenditures in this drug class have increased significantly in recent months and we wanted to assess the extent of the utilization that was “off reimbursement criteria” (i.e., use outside of T2DM) because these drugs have demonstrated efficacy in other conditions that are not currently publicly funded but have regulatory approval (e.g., weight management). Ozempic (semaglutide injection) is the dominant GLP-1 RA brand (> 99% market share among public PT drug plans) and expenditures on it have accelerated. Expenditures on Ozempic have increased from $13.5 million in 2019 to $227 million in 2021. Increasing use of Ozempic can be partially attributed to non-T2DM claims. The proportion of claimants with suspected use outside of T2DM was 15% in Ontario and ranged from 0% to 8% across the other PT public drug plans; suspected use outside of T2DM is projected to be 1 in 5 claimants in Ontario in 2022. Among non-formulary claims (e.g., federal public plans, private insurance), this proportion ranged from 36% to 74% (data from 2021).
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it