Glucagon-like peptide 1 receptor agonists and healthcare use in older adults with heart failure and obesity

Background: Glucagon-like peptide 1 receptor agonists (GLP-1 RA) are indicated for weight reduction and offer cardiometabolic health benefits, yet there is little real-world evidence regarding their association with healthcare resource utilization (HCRU) and costs for Medicare Advantage (MA) beneficiaries with heart failure and obesity. Methods: We used a prevalent new-user study design and the Humana Healthcare Research database to identify MA beneficiaries with heart failure (HF) and obesity receiving standard HF therapy or HF therapy + newly initiating GLP-1 RA between January 1, 2022, and December 31, 2023. We observed adjusted, one-year mean difference in all-cause and heart failure-related HCRU. Results: In our cohort of 4,677 matched pairs (mean age 72 years, male: 41%), one-year, adjusted risk ratio (RR) for HF therapy + GLP-1 RA vs HF therapy was 0.89 (95% CI: 0.84 ? 0.93) for all-cause inpatient utilization, 0.88 (95% CI: 0.82 ? 0.94) for avoidable hospitalizations, and 0.99 (95% CI: 0.95 ? 1.03) for emergency department visits. For individuals receiving HF therapy + GLP-1 RA vs HF therapy, the mean difference was 30.6% (95% CI: 26.7% ?34.7%) for all-cause total costs, 105.9% (95% CI: 99.1% ?112.9%) for pharmacy costs, and ?4.7% (95% CI: ?8.7% to ?0.6%) for medical costs. HF-related HCRU measures were lower among beneficiaries augmenting HF therapy with GLP 1 RA vs individuals receiving HF therapy alone. Conclusions: Among MA beneficiaries with heart failure and obesity, the addition of GLP-1 RA to standard heart failure therapy reduced the likelihood of inpatient admissions or avoidable hospitalizations compared with HF therapy alone.