Over Half of GLP-1 Discontinuers Restart Within a Year in U.S. Claims Data

The Komodo Health claims analysis defined discontinuation as a greater than 60-day prescription gap among adults aged 18-64 with BMI at least 25 who initiated liraglutide, semaglutide or tirzepatide. Cox models identified higher discontinuation among Medicaid or Medicare enrollees, Black patients and those reporting nausea or gastrointestinal side effects, while endocrinologist prescribing reduced stopping risk by 10%. Tirzepatide users showed 41% lower discontinuation than liraglutide users. Real-world cycling contrasts sharply with sustained-use assumptions in cardiovascular outcome trials such as SELECT and SURPASS, where adherence exceeded 80% under protocol conditions. Inconsistent exposure likely attenuates documented reductions in major adverse cardiovascular events and kidney disease progression. Restart patterns also reveal substantial repeat administrative and out-of-pocket costs not captured in short-term trial economics.