Sociodemographic disparities in semaglutide and tirzepatide prescription for obesity treatment.

Introduction: Semaglutide and tirzepatide, the 2 most recently approved glucagon-like peptide-1 receptor agonists, have demonstrated substantial effectiveness in weight management. However, evidence on treatment inequities remains 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 years 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 health care provider socioeconomic status. Results: Six-month cumulative incidence of prescription increased from 1.9% to 16.6% over the study period. Higher access was associated with being female, non-Hispanic White, in higher body mass index categories, and seen at a higher socioeconomic status (SES)-quartile provider. Uptake was significantly lower in lower provider neighborhood SES groups (lowest quartile adjusted odds ratio: 0.75; 95% CI: 0.73-0.78, compared with the highest quartile), and the differences widened over time. The 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 pharmaco-equity in drug benefit design are needed to prevent these therapies from exacerbating existing health disparities.