{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T16:07:11Z","timestamp":1781626031190,"version":"3.54.5"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T00:00:00Z","timestamp":1780099200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007181","name":"Quality Enhancement Research Initiative","doi-asserted-by":"publisher","award":["PEC 16-001"],"award-info":[{"award-number":["PEC 16-001"]}],"id":[{"id":"10.13039\/100007181","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Obesity is an increasing chronic medical condition facing the veteran population. Glucagon-like peptide 1 receptor agonists (GLP-1s) have emerged as an optimal treatment for obesity- and related-medical disorders. As the Veterans Health Administration (VHA) continues to expand community-based care purchased under the MISSION Act, it is unknown whether veterans receiving community-based primary care experience comparable access to GLP-1 prescriptions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this national analysis of VHA data, we assessed differences in GLP-1 prescribing among veterans with overweight or obesity in VHA direct care compared with community care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Veterans with 3 or more primary care visits receiving VHA-direct primary care had 1.2 percentage points (pp) higher adjusted probability of GLP-1 prescriptions (20% higher odds) than veterans receiving mostly community primary care. Black and Asian veterans had 1.8-pp and 2.2-pp lower probabilities of GLP-1 prescriptions (26% and 34% lower odds, respectively) compared with White counterparts across both settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Researchers and policymakers should continue to monitor whether differences in care between the direct and community settings contribute to disparities in GLP-1 access.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/haschl\/qxag130","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T11:44:05Z","timestamp":1779968645000},"source":"Crossref","is-referenced-by-count":0,"title":["Racial and ethnic disparities in GLP-1 prescriptions among veterans with obesity across direct and community care settings"],"prefix":"10.1093","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-0651-7170","authenticated-orcid":false,"given":"Rebekah I","family":"Stein","sequence":"first","affiliation":[{"name":"Department of Health Policy & Management, Harvard T.H. Chan School of Public Health , Boston, MA 02115 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Phelan","sequence":"additional","affiliation":[{"name":"Department of Health Policy & Management, Harvard T.H. Chan School of Public Health , Boston, MA 02115 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Austin B","family":"Frakt","sequence":"additional","affiliation":[{"name":"Department of Health Policy & Management, Harvard T.H. Chan School of Public Health , Boston, MA 02115 ,","place":["United States"]},{"name":"Boston VA Healthcare System Partnered Evidence-based Policy Resource Center, , Boston, MA 02130 ,","place":["United States"]},{"name":"Joint Commission Research Center, Joint Commission , Oakbrook Terrace, IL 60181 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4908-5976","authenticated-orcid":false,"given":"Steven D","family":"Pizer","sequence":"additional","affiliation":[{"name":"Boston VA Healthcare System Partnered Evidence-based Policy Resource Center, , Boston, MA 02130 ,","place":["United States"]},{"name":"Department of Health Law, Policy & Management, Boston University School of Public Health , Boston, MA 02118 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8986-3536","authenticated-orcid":false,"given":"Melissa","family":"Garrido","sequence":"additional","affiliation":[{"name":"Boston VA Healthcare System Partnered Evidence-based Policy Resource Center, , Boston, MA 02130 ,","place":["United States"]},{"name":"Department of Health Law, Policy & Management, Boston University School of Public Health , Boston, MA 02118 ,","place":["United States"]},{"name":"Department of Surgery, Brigham and Women's Hospital , Boston, MA 02115 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8886-7252","authenticated-orcid":false,"given":"E John","family":"Orav","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital , Boston, MA 02115 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3811-257X","authenticated-orcid":false,"given":"Jose F","family":"Figueroa","sequence":"additional","affiliation":[{"name":"Department of Health Policy & Management, Harvard T.H. Chan School of Public Health , Boston, MA 02115 ,","place":["United States"]},{"name":"Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital , Boston, MA 02115 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9183-016X","authenticated-orcid":false,"given":"Thomas C","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Health Policy & Management, Harvard T.H. Chan School of Public Health , Boston, MA 02115 ,","place":["United States"]},{"name":"Department of Surgery, Brigham and Women's Hospital , Boston, MA 02115 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,5,29]]},"reference":[{"issue":"5","key":"2026061611422951500_qxag130-B1","doi-asserted-by":"publisher","first-page":"5","DOI":"10.3390\/healthcare9050604","article-title":"Exploring health outcomes for U.S. veterans compared to non-veterans from 2003 to 2019","volume":"9","author":"Betancourt","year":"2021","journal-title":"Healthcare (Basel)"},{"key":"2026061611422951500_qxag130-B2","author":"Department of Veterans Affairs\/Department of Defense (VA\/DoD)"},{"issue":"S1","key":"2026061611422951500_qxag130-B3","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1007\/s11606-016-3962-1","article-title":"The obesity epidemic in the Veterans Health Administration: prevalence among key populations of women and men veterans","volume":"32","author":"Breland","year":"2017","journal-title":"J Gen Intern Med"},{"key":"2026061611422951500_qxag130-B4","author":"Collins","year":"2024"},{"issue":"3","key":"2026061611422951500_qxag130-B5","doi-asserted-by":"publisher","first-page":"723","DOI":"10.1007\/s12325-022-02394-w","article-title":"GLP-1 agonists for weight loss: pharmacology and clinical implications","volume":"40","author":"Moore","year":"2023","journal-title":"Adv Ther"},{"issue":"3","key":"2026061611422951500_qxag130-B6","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1016\/j.clinthera.2023.12.014","article-title":"Use of dulaglutide, semaglutide, and tirzepatide in diabetes and weight management","volume":"46","author":"Powell","year":"2024","journal-title":"Clin Ther"},{"issue":"4","key":"2026061611422951500_qxag130-B7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1017\/S1744133124000306","article-title":"The prevalence and consequences of support for off-label Ozempic prescriptions","volume":"7","author":"Callaghan","year":"2025","journal-title":"Health Econ Policy Law"},{"issue":"14","key":"2026061611422951500_qxag130-B8","doi-asserted-by":"publisher","first-page":"1230","DOI":"10.1001\/jama.2024.3073","article-title":"State coverage and reimbursement of antiobesity medications in Medicaid","volume":"331","author":"Liu","year":"2024","journal-title":"JAMA"},{"key":"2026061611422951500_qxag130-B9","doi-asserted-by":"publisher","author":"Pearson","DOI":"10.57264\/cer-2025-0083"},{"key":"2026061611422951500_qxag130-B10","author":"McGough"},{"key":"2026061611422951500_qxag130-B11","author":"Williams"},{"key":"2026061611422951500_qxag130-B12","author":"Wreschnig"},{"key":"2026061611422951500_qxag130-B13","author":"Rogers"},{"key":"2026061611422951500_qxag130-B14","author":"Isakson"},{"key":"2026061611422951500_qxag130-B15","author":"US Department of Veterans Affairs"},{"issue":"7","key":"2026061611422951500_qxag130-B16","doi-asserted-by":"publisher","first-page":"675","DOI":"10.1177\/1060028019828681","article-title":"The impact of dual health care system use for obtaining prescription medications on nonadherence in veterans with type 2 diabetes","volume":"53","author":"Taber","year":"2019","journal-title":"Ann Pharmacother"},{"issue":"5","key":"2026061611422951500_qxag130-B17","doi-asserted-by":"publisher","first-page":"e14621","DOI":"10.1111\/1475-6773.14621","article-title":"Clocking injustice: racial disparities in specialty wait times","volume":"60","author":"Asfaw","year":"2025","journal-title":"Health Serv Res"},{"issue":"6","key":"2026061611422951500_qxag130-B18","doi-asserted-by":"publisher","first-page":"e241568","DOI":"10.1001\/jamahealthforum.2024.1568","article-title":"Racial and ethnic and rural variations in access to primary care for veterans following the MISSION act","volume":"5","author":"Rosen","year":"2024","journal-title":"JAMA Health Forum"},{"issue":"11","key":"2026061611422951500_qxag130-B19","doi-asserted-by":"publisher","first-page":"1479","DOI":"10.2215\/CJN.0000000000000266","article-title":"Racial and ethnic disparities and facility-level variation in GLP-1 RA prescription among US veterans with CKD","volume":"18","author":"Gregg","year":"2023","journal-title":"Clin J Am Soc Nephrol"},{"issue":"2","key":"2026061611422951500_qxag130-B20","doi-asserted-by":"publisher","first-page":"372","DOI":"10.2337\/dc21-1815","article-title":"Utilization rates of SGLT2 inhibitors and GLP-1 receptor agonists and their facility-level variation among patients with atherosclerotic cardiovascular disease and type 2 diabetes: insights from the Department of Veterans Affairs","volume":"45","author":"Mahtta","year":"2022","journal-title":"Diabetes Care"},{"key":"2026061611422951500_qxag130-B21","doi-asserted-by":"publisher","first-page":"100966","DOI":"10.1016\/j.ajpc.2025.100966","article-title":"Evidence-based SGLT2 inhibitor and GLP-1 receptor agonist use by race in the VA healthcare system","volume":"22","author":"Bolden","year":"2025","journal-title":"Am J Prev Cardiol"},{"issue":"9","key":"2026061611422951500_qxag130-B22","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1001\/jama.2022.13885","article-title":"Association of race and ethnicity with prescription of SGLT2 inhibitors and GLP1 receptor agonists among patients with type 2 diabetes in the Veterans Health Administration system","volume":"328","author":"Lamprea-Montealegre","year":"2022","journal-title":"JAMA"},{"issue":"6 Pt 2","key":"2026061611422951500_qxag130-B23","doi-asserted-by":"publisher","first-page":"101819","DOI":"10.1016\/j.jacadv.2025.101819","article-title":"Differential selection of obesity treatments by race\/ethnicity: insights from the Veterans Affairs healthcare system","volume":"4","author":"Tisdale","year":"2025","journal-title":"JACC Adv"},{"issue":"1","key":"2026061611422951500_qxag130-B24","doi-asserted-by":"publisher","first-page":"e011649","DOI":"10.1161\/CIRCOUTCOMES.124.011649","article-title":"Racial and ethnic differences in semaglutide prescriptions for veterans with overweight or obesity in the Veterans Affairs healthcare system","volume":"18","author":"Tisdale","year":"2025","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"2026061611422951500_qxag130-B25","author":"Department of Veterans Affairs (VA) Office of Health Equity"},{"issue":"10","key":"2026061611422951500_qxag130-B26","doi-asserted-by":"publisher","first-page":"e2540890","DOI":"10.1001\/jamanetworkopen.2025.40890","article-title":"Prescribing trends of glucagon-like peptide 1 receptor agonists for type 2 diabetes or obesity","volume":"8","author":"Li","year":"2025","journal-title":"JAMA Netw Open"},{"issue":"10","key":"2026061611422951500_qxag130-B27","doi-asserted-by":"publisher","first-page":"1058","DOI":"10.1001\/jamasurg.2025.3089","article-title":"Use of glucagon-like peptide-1 agonists among individuals undergoing bariatric surgery in the US","volume":"27","author":"Kim","year":"2025","journal-title":"JAMA Surg"},{"issue":"5","key":"2026061611422951500_qxag130-B28","doi-asserted-by":"publisher","first-page":"910","DOI":"10.1111\/j.1532-5415.2012.03933.x","article-title":"Underuse of diagnostic codes for specific dementias in the Veterans Affairs New England healthcare system","volume":"60","author":"Butler","year":"2012","journal-title":"J Am Geriatr Soc"},{"issue":"11","key":"2026061611422951500_qxag130-B29","doi-asserted-by":"publisher","first-page":"1529","DOI":"10.3390\/healthcare11111529","article-title":"Relationship between body mass Index and diagnosis of overweight or obesity in Veterans Administration population","volume":"11","author":"Baser","year":"2023","journal-title":"Healthcare (Basel)"},{"key":"2026061611422951500_qxag130-B30","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.ypmed.2014.04.010","article-title":"Using appropriate body mass index cut points for overweight and obesity among Asian Americans","volume":"65","author":"Jih","year":"2014","journal-title":"Prev Med"},{"issue":"8","key":"2026061611422951500_qxag130-B31","doi-asserted-by":"publisher","first-page":"356","DOI":"10.12788\/fp.0296","article-title":"Value of a pharmacy-adjudicated community care prior authorization drug request service","volume":"39","author":"Jennings","year":"2022","journal-title":"Fed Pract"},{"issue":"Suppl 3","key":"2026061611422951500_qxag130-B32","doi-asserted-by":"publisher","first-page":"821","DOI":"10.1007\/s11606-023-08126-2","article-title":"Jumping through hoops: community care clinician and staff experiences providing primary care to rural veterans","volume":"38","author":"Patzel","year":"2023","journal-title":"J Gen Intern Med"},{"issue":"3","key":"2026061611422951500_qxag130-B33","doi-asserted-by":"publisher","first-page":"755","DOI":"10.1111\/j.1530-9134.2005.00081.x","article-title":"Spillover effects of restrictive drug formularies on physician prescribing behavior: evidence from Medicaid","volume":"14","author":"Wang","year":"2005","journal-title":"J Econ Manag Strategy"},{"issue":"6","key":"2026061611422951500_qxag130-B34","doi-asserted-by":"publisher","first-page":"3113","DOI":"10.1111\/dom.16318","article-title":"Regional trends and disparities in newer GLP1 receptor agonist initiation among real-world adult patients eligible for obesity treatment","volume":"27","author":"Radwan","year":"2025","journal-title":"Diabetes Obes Metab"},{"issue":"5","key":"2026061611422951500_qxag130-B35","doi-asserted-by":"publisher","first-page":"1687","DOI":"10.1111\/dom.15473","article-title":"Association of patient characteristics and insurance type with anti-obesity medications prescribing and fills","volume":"26","author":"Gasoyan","year":"2024","journal-title":"Diabetes Obes Metab"},{"issue":"19","key":"2026061611422951500_qxag130-B36","doi-asserted-by":"publisher","first-page":"e025545","DOI":"10.1161\/JAHA.121.025545","article-title":"Racial and ethnic disparities in financial barriers among overweight and obese adults eligible for semaglutide in the United States","volume":"11","author":"Lu","year":"2022","journal-title":"J Am Heart Assoc"},{"issue":"8","key":"2026061611422951500_qxag130-B37","doi-asserted-by":"publisher","first-page":"895","DOI":"10.1111\/acem.13214","article-title":"A systematic review of the impact of physician implicit racial bias on clinical decision making","volume":"24","author":"Dehon","year":"2017","journal-title":"Acad Emerg Med"},{"issue":"4","key":"2026061611422951500_qxag130-B38","doi-asserted-by":"publisher","first-page":"927","DOI":"10.1007\/s40615-020-00850-3","article-title":"Poor medication adherence in African Americans Is a matter of trust","volume":"8","author":"Hall","year":"2021","journal-title":"J. Racial Ethn Health Disparities"},{"issue":"2","key":"2026061611422951500_qxag130-B39","doi-asserted-by":"publisher","first-page":"311","DOI":"10.2337\/dc08-1307","article-title":"Racial\/ethnic differences in concerns about current and future medications among patients with type 2 diabetes","volume":"32","author":"Huang","year":"2009","journal-title":"Diabetes Care"}],"container-title":["Health Affairs Scholar"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/healthaffairsscholar\/advance-article-pdf\/doi\/10.1093\/haschl\/qxag130\/68434621\/qxag130.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/healthaffairsscholar\/article-pdf\/4\/6\/qxag130\/68434621\/qxag130.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/healthaffairsscholar\/article-pdf\/4\/6\/qxag130\/68434621\/qxag130.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T15:42:40Z","timestamp":1781624560000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/healthaffairsscholar\/article\/doi\/10.1093\/haschl\/qxag130\/8698347"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,29]]},"references-count":39,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,5,29]]}},"URL":"https:\/\/doi.org\/10.1093\/haschl\/qxag130","relation":{},"ISSN":["2976-5390"],"issn-type":[{"value":"2976-5390","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,6]]},"published":{"date-parts":[[2026,5,29]]},"article-number":"qxag130"}}