Supplementary data: Healthcare costs and treatment patterns associated with glucagon-like peptide 1 receptor agonist use among patients with metabolic dysfunction-associated steatohepatitis

<p dir="ltr"><b>These are peer-reviewed supplementary materials for the article</b><b> </b><b>'</b><b>Healthcare costs and treatment patterns </b><b>associated with glucagon-like peptide 1 </b><b>receptor agonist use among patients with </b><b>metabolic dysfunction-associated </b><b>steatohepatitis</b><b>'</b><b> </b><b>published in the</b><b> </b><b><i>Journal of Comparative Effectiveness Research</i></b><b>.</b></p><ul><li><b>Supplementary table 1: </b>Codes for Study Execution</li><li><b>Supplementary table 2: </b>Glucagon-like peptide-1 receptor agonists dosing classification</li><li><b>Supplementary table 3: </b>Body Mass Index</li><li><b>Supplementary table 4: </b>Incident diagnoses of severe liver outcomes in the follow-up period^a</li><li><b>Supplementary table 5: </b>Exploratory Analysis of Reasons for Discontinuation</li><li><b>Supplementary table 6: </b>All-cause healthcare resource utilization in the baseline and follow-up periods</li></ul><p dir="ltr"><b>Aim: </b>While only recently approved for the treatment of metabolic dysfunction-associated steatohepatitis (MASH), many patients with MASH have taken glucagon-like peptide-1 receptor agonists (GLP-1 RAs) for the treatment of comorbid Type 2 diabetes (T2D) or obesity. This real-world study evaluated treatment patterns, weight loss, healthcare resource utilization, and costs among patients with MASH who initiated GLP-1 RAs. <b>Materials & methods: </b>In a linked electronic health records (Veradigm Network EHR) and claims (Komodo Health) dataset, we identified adults (≥18 years old) with a MASH diagnosis who initiated GLP-1 RA treatment (1 July 2018 to 30 April 2023; index date = date of the first GLP-1 RA claim). Patients with other causes of liver disease or severe complications from MASH were excluded.We required ≥12 months of continuous enrollment pre- (baseline) and post-index (follow-up). Patients were stratified into high and low-dose subgroups. We also identified a comparator cohort of patients who initiated a different class of T2D medication (DPP4, SGLT2, or sulfonylurea) during the same time period. We captured patient characteristics, change in BMI, GLP-1 RA treatment patterns, liver-related events, healthcare utilization, and costs. <b>Results:</b> We identified 10,316 patients with MASH who initiated a GLP-1 RA (high dose: 2043 [19.8%]; low dose: 8273 [80.2%]) and 2915 who initiated a non-GLP-1 RA T2D medication. GLP-1 RA users were 52.7 years old and 64.3% female. A 5.8% decrease in the percentage of patients with class III obesity was observed among GLP-1 RA users (10.7% among high-dose users; 0.8% among non-users). Overall, 56.1% of GLP-1 RA users discontinued during the 12-month follow-up. Total costs among GLP-1 RA users and non users were $20,912 and $19,019 in the baseline period and $27,586 and $24,917 in the follow-up period, respectively. Medical costs among GLP-1 RA users were $16,293 (baseline) and $16,886 (followup). Results were similar for high and low-dose subgroups. <b>Conclusion: </b>Although some patients with MASH on GLP-1 RAs, particularly those taking higher dosages, may achieve weight loss, outcomes remain suboptimal with frequent discontinuation and high healthcare costs. Real-world GLP-1 RA utilization may be insufficient for resolving chronic metabolic issues, including MASH.</p>