Comparison of Medicare Semaglutide Prescribing and End Stage Renal Disease by State

Abstract

Purpose: Glucagon-like-peptide-1 (GLP-1) agonists are anti-diabetic drugs that are an efficacious and cost-effective option in achieving glycemic goals in type 2 diabetes. The American Diabetes Association (ADA) 2025 guidelines mention semaglutide’s potential benefits in reducing kidney disease progression. According to the Centers for Disease Control and Prevention (CDC), roughly 35.5 million people in the United States have chronic kidney disease (CKD). This study aims to analyze the correlation between semaglutide prescriptions and end stage renal disease diagnoses among the 50 states.

Methods: This study was a retrospective, evaluative study utilizing state prescription data from the 2021 Medicare Provider Utilization and Payment Data: Part D Prescriber Data. This data was downloaded to obtain semaglutide claims and beneficiaries for all states from 2021. The data for 2022 ESRD prevalence rates was obtained from the National Institute of Diabetes and Digestive and Kidney Disease. Raw data for semaglutide claims were adjusted for population differences by dividing the claims per state by the total state beneficiaries, then multiplying by 1000. The ESRD rates were also adjusted for population differences by dividing the rate per state by the census state population, then multiplying by 100,000. Graphs and heat maps were generated utilizing Google Sheets to visually compare prescribing trends and ESRD diagnoses.

Results: Based on the data collected from 2022, the top five states with the lowest rate of ESRD diagnoses include Vermont, Wyoming, Utah, New Hampshire, and Idaho. Of the top 10 states with the lowest rate of ESRD diagnoses, only Alaska and North Dakota were among the top 10 states with the highest semaglutide prescribing rate in 2021. Of the top 10 states with the highest rates of ESRD diagnoses, Utah, New Hampshire, and Colorado were among the top 10 states with the lowest semaglutide prescribing rate. Conversely, of the top 15 states with the lowest ESRD diagnoses, three states including Maine, Oregon, and Rhode Island, were among the top 15 states with the lowest semaglutide prescribing rate.

Conclusion: There is a possible correlation between semaglutide prescription rates in 2021 and less ESRD diagnoses in 2022. The main limitation of this study was that semaglutide claims were only collected from the Medicare Part D data. Further studies with a larger sample size and greater variety of population are required to determine a possible correlation.