Switching patterns of GLP-1 receptor agonists from 2018 to 2025 in the largest private healthcare network in Poland

May 16, 2026Acta diabetologica

Changes in Use of GLP-1 Receptor Agonists from 2018 to 2025 in Poland’s Largest Private Healthcare Network

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Abstract

Overall, 29.7% of patients switched at least once among GLP-1 receptor agonists.

A total of 42,423 patients were analyzed, contributing to 27,095 prescription transitions.
Liraglutide was associated with significantly lower odds of switching compared to subcutaneous semaglutide.
Oral semaglutide and dulaglutide did not show significant differences in switching behavior compared to subcutaneous semaglutide.
Temporal patterns indicated peaks in switching may relate to episodic substitution and increased use of tirzepatide after its market entry.
The study found that switching behavior is influenced by time and specific therapies, but reasons for switching were not measured.

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AIMS: To characterize switching among GLP-1 receptor agonists (GLP-1 RAs) in a large private-sector cohort in Poland and to quantify therapy- and patient-level associations with switching while accounting for switching opportunity and calendar-time dynamics.

METHODS: We conducted a retrospective analysis of GLP-1 RA prescription records from the LUX MED network (2018-2025). Switching was defined as any change in agent between consecutive prescriptions. Patients with more than one prescription were included (n = 42,423). The primary analysis used a transition-level discrete-time hazard model in which each prescription-to-prescription interval contributed one observation, and the outcome was switching at that interval. Current-therapy contrasts were reported relative to subcutaneous semaglutide. Sensitivity analyses examined alternative temporal parameterizations and additional adjustment for elapsed time.

RESULTS: Overall, 29.7% of patients switched at least once and 14.3% switched two or more times. In the transition-level analysis, 12,620 patients contributed 27,095 transitions. After adjustment for opportunity and calendar time, liraglutide was associated with substantially lower odds of switching compared with subcutaneous semaglutide (OR, 0.02; 95% CI, 0.01-0.03), whereas oral semaglutide (OR, 1.30; 95% CI, 0.78-2.17) and dulaglutide (OR, 1.70; 95% CI, 0.95-3.04) did not differ significantly. Temporal analyses revealed peaks consistent with episodic substitution and accelerated tirzepatide uptake after market entry. The principal associations remained directionally consistent in sensitivity analyses.

CONCLUSIONS: Switching among GLP-1 RAs is common and time-dependent. Time-aware modelling identified therapy-specific switching patterns and pronounced temporal variation; reasons for switching remain unmeasured, and the observed associations should be interpreted as hypothesis-generating.

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Switching patterns of GLP-1 receptor agonists from 2018 to 2025 in the largest private healthcare network in Poland

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