{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T03:51:03Z","timestamp":1792036263520,"version":"4.4.0"},"reference-count":26,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Glucagon\u2010like peptide\u20101 (GLP\u20101) receptor agonist\u2010based medicines are highly effective treatments for overweight and obesity, but population\u2010scale real\u2010world evidence remains limited, particularly in self\u2010funded settings where treatment choice may be influenced by relative price. We aimed to characterise provider reach and treatment patterns through a large United Kingdom (UK) telehealth provider, assess changes around the September 2025 tirzepatide list\u2010price increase of up to 170%, and estimate longitudinal weight trajectories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study of adults initiating semaglutide or tirzepatide through MedExpress from 1 May 2024 to 1 January 2026 was conducted. Treatment initiation and switching were analysed using segmented interrupted time\u2010series models, with sensitivity analyses addressing anticipatory changes in August 2025. Weight trajectories were estimated using linear mixed\u2010effects models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 1\u2009033\u2009522 adults, 932\u2009659 (90.2%) initiated tirzepatide and 100\u2009863 (9.8%) semaglutide; provider reach was higher among women than men. In September 2025, semaglutide initiation increased by 31.15 percentage points (95% CI: 26.07\u201336.24) relative to the projected pre\u2010interruption trend. Tirzepatide\u2010to\u2010semaglutide switching increased by 9.26 percentage points (95% CI: 7.09\u201311.42) and subsequently attenuated. Sensitivity analyses supported anticipatory changes in August. At 12\u2009months, estimated weight loss was 19.93% with tirzepatide (95% CI: 19.88\u201319.98;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200930\u2009763) and 16.40% with semaglutide (95% CI: 16.16\u201316.64;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009979).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A single UK telehealth provider achieved substantial reach among adults with overweight or obesity. Treatment initiation and switching changed markedly around the tirzepatide price increase. Substantial longitudinal weight loss was observed among patients contributing follow\u2010up in the context of limited adjunctive lifestyle support.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.71410","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T03:29:11Z","timestamp":1792034951000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real\u2010World Treatment Patterns and Weight Outcomes Before and After a Tirzepatide Price Increase in Over One Million Self\u2010Paying\n                    <scp>UK<\/scp>\n                    Adults With Overweight or Obesity"],"prefix":"10.1111","author":[{"given":"Sophie","family":"Dix","sequence":"first","affiliation":[{"name":"HeliosX  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Mulligan","sequence":"additional","affiliation":[{"name":"Health Analytics, Lane Clark &amp; Peacock LLP  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattia","family":"Ficarelli","sequence":"additional","affiliation":[{"name":"Health Analytics, Lane Clark &amp; Peacock LLP  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Brooke","sequence":"additional","affiliation":[{"name":"HeliosX  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Onayomi","family":"Rosenior\u2010Patten","sequence":"additional","affiliation":[{"name":"HeliosX  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9286-973X","authenticated-orcid":false,"given":"Simon","family":"Chen","sequence":"additional","affiliation":[{"name":"Health Analytics, Lane Clark &amp; Peacock LLP  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catriona","family":"Maybury","sequence":"additional","affiliation":[{"name":"HeliosX  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8983-7530","authenticated-orcid":false,"given":"Benjamin D.","family":"Bray","sequence":"additional","affiliation":[{"name":"Health Analytics, Lane Clark &amp; Peacock LLP  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/IJ9.0000000000000017"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(23)02750\u20102"},{"key":"e_1_2_9_4_1","unstructured":"NHS Digital \u201cThe Health Survey for England 2024 \u201d(2026) https:\/\/digital.nhs.uk\/data\u2010and\u2010information\/publications\/statistical\/health\u2010survey\u2010for\u2010england\/2024\/."},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mpmed.2018.10.004"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj\u20102021\u2010067516"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(20)30752\u20102"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(22)01438\u20106"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(25)01853\u20107"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2032183"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2206038"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2022.101737"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.15272"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2307563"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.91a.24068"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2011.387"},{"key":"e_1_2_9_17_1","unstructured":"National Institute for Health and Care Excellence (NICE) \u201cTirzepatide for Managing Overweight and Obesity TA1026 \u201d(2024) https:\/\/www.nice.org.uk\/guidance\/ta1026."},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916\u2010025\u201004528\u20107"},{"key":"e_1_2_9_19_1","unstructured":"M.Fox \u201cPrivate Pathways Dr ChatGPT and the Biosimilar Boom\u2014Three Topics That Executives in UK Life Sciences Organisations Can't Avoid in 2026 \u201d(2026) https:\/\/www.iqvia.com\/locations\/united\u2010kingdom\/blogs\/2026\/03\/private\u2010pathways\u2010dr\u2010chatgpt\u2010and\u2010the\u2010biosimilar\u2010boom."},{"key":"e_1_2_9_20_1","unstructured":"S.Field J.Clarke andC.Tallack \u201cGLP\u20101 Drug Prescriptions for Obesity \u201d(2026) https:\/\/www.health.org.uk\/reports\u2010and\u2010analysis\/analysis\/glp\u20101\u2010drug\u2010prescriptions\u2010for\u2010obesity."},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1211\/PJ.2025.1.371400"},{"key":"e_1_2_9_22_1","unstructured":"National Institute for Health and Care Excellence (NICE) \u201cSemaglutide for Managing Overweight and Obesity: Technology Appraisal Guidance TA875 \u201d(2023) https:\/\/www.nice.org.uk\/guidance\/ta875."},{"key":"e_1_2_9_23_1","unstructured":"Office for National Statistics (ONS) \u201cEstimates of the Population for the UK England Wales Scotland and Northern Ireland \u201d(2025) https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/populationandmigration\/populationestimates\/datasets\/populationestimatesforukenglandandwalesscotlandandnorthernireland."},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586\u2010026\u201010383\u20100"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1211\/PJ.2025.1.369942"},{"key":"e_1_2_9_26_1","unstructured":"M.Fick \u201cLilly to Hike UK Price of Mounjaro Weight\u2010Loss Drug by 170%. Reuters \u201d(2025)."},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.71067"}],"container-title":["Diabetes, Obesity and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dom-pubs.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dom.71410","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/dom-pubs.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/dom.71410","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/dom-pubs.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dom.71410","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T03:29:15Z","timestamp":1792034955000},"score":1,"resource":{"primary":{"URL":"https:\/\/dom-pubs.onlinelibrary.wiley.com\/doi\/10.1111\/dom.71410"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,14]]},"references-count":26,"alternative-id":["10.1111\/dom.71410"],"URL":"https:\/\/doi.org\/10.1111\/dom.71410","archive":["Portico"],"relation":{},"ISSN":["1462-8902","1463-1326"],"issn-type":[{"value":"1462-8902","type":"print"},{"value":"1463-1326","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,14]]},"assertion":[{"value":"2026-05-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"dom.71410"}}