Semaglutide (Ozempic^®) Use in Denmark 2018 Through 2023 ‒ User Trends and off-Label Prescribing for Weight Loss

Figures & data

Figure 1 Quarterly incidence rate of new users (A) and quarterly total user prevalence (B) of semaglutide injection (Ozempic^®) in Denmark, 2018–2023. Use of other GLP-1RAs and older weight loss medications shown as comparison.

Table 1 Characteristics of All New Initiators of Semaglutide Injection (Ozempic^®) in Denmark from January 2018 to December 2023, and Characteristics of Prevalent Users in 2023

	2018	2019	2020	2021	2022	2023	Prevalent users in 2023
Total number of users	5744 (100.0)	16,596 (100.0)	16,035 (100.0)	19,620 (100.0)	31,340 (100.0)	24,677 (100.0)	91,626 (100.0)
Sex
Male	3317 (57.8)	9592 (57.8)	8899 (55.5)	10,125 (51.6)	14,111 (45.0)	12,758 (51.7)	47,908 (52.3)
Female	2427 (42.3)	7004 (42.2)	7136 (44.5)	9495 (48.4)	17,229 (55.0)	11,919 (48.3)	43,718 (47.7)
Age
Median (quartiles)	62 (54;70)	62 (54;71)	62 (53;71)	60 (51;70)	57 (48;67)	60 (51;69)	62 (53;71)
Proportion <40 years	252 (4.4)	777 (4.7)	985 (6.1)	1698 (8.7)	3990 (12.7)	2079 (8.4)	5983 (6.5)
Indicators of diabetes presence
Any diabetes record	5700 (99.2)	16,299 (98.2)	15,224 (94.9)	16,740 (85.3)	21,134 (67.4)	21,512 (87.2)	80,672 (88.0)
Hospital admissions with ICD code for diabetes	4742 (82.6)	12,638 (76.2)	10,716 (66.8)	10,527 (53.7)	11,148 (35.6)	10,132 (41.1)	51,385 (56.1)
Any antidiabetic medication^a	5689 (99.0)	16,224 (97.8)	15,060 (93.9)	16,352 (83.3)	20,255 (64.6)	20,334 (82.4)	78,791 (86.0)
HbA1c ≥48 mmol/mol	5606 (97.6)	16,058 (96.8)	14,910 (93.0)	16,208 (82.6)	19,867 (63.4)	20,981 (85.0)	78,613 (85.8)
No diabetes record (neither HbA1c ≥48 mmol/mol nor antidiabetic medication nor ICD code for diabetes)	44 (0.8)	297 (1.8)	811 (5.1)	2880 (14.7)	10,206 (32.6)	3165 (12.8)	11,013 (12.0)
Prediabetes: No diabetes record, but HbA1c 42–47 mmol/mol	7 (0.1)	44 (0.3)	101 (0.6)	413 (2.1)	1545 (4.9)	520 (2.1)	1697 (1.9)
Number of antidiabetic medications used at baseline
No therapy	87 (1.5)	534 (3.2)	1254 (7.8)	3699 (18.9)	12,108 (38.6)	4964 (20.1)	18,532 (20.2)
Monotherapy	656 (11.4)	2817 (17.0)	3671 (22.9)	5045 (25.7)	7591 (24.2)	8430 (34.2)	28,715 (31.3)
Dual therapy	1778 (31.0)	5677 (34.2)	5536 (34.5)	5712 (29.1)	6341 (20.2)	6721 (27.2)	27,715 (30.3)
≥3 medications	3223 (56.1)	7568 (45.6)	5574 (34.8)	5164 (26.3)	5300 (16.9)	4562 (18.5)	16,664 (18.2)
Type of antidiabetic medications used at baseline
Insulin	2723 (47.4)	6808 (41.0)	5117 (31.9)	4684 (23.9)	4361 (13.9)	3660 (14.8)	21,362 (23.3)
Metformin	4893 (85.2)	13,971 (84.2)	12,898 (80.4)	13,873 (70.7)	16,847 (53.8)	17,325 (70.2)	61,948 (67.6)
SGLT-2i	2278 (39.7)	6067 (36.6)	5753 (35.9)	6451 (32.9)	7855 (25.1)	8296 (33.6)	33,891 (37.0)
DPP-4i	1237 (21.5)	3996 (24.1)	3682 (23.0)	3485 (17.8)	3550 (11.3)	2880 (11.7)	4341 (4.7)
Other antidiabetic medications (except GLP-1RAs)	674 (11.7)	1892 (11.4)	1520 (9.5)	1304 (6.7)	1209 (3.9)	951 (3.9)	2817 (3.1)
GLP-1RA, Victoza^®	3047 (53.1)	5987 (36.1)	3516 (21.9)	2583 (13.2)	2086 (6.7)	1450 (5.9)	2287 (2.5)
GLP-1RA, Saxenda^®	28 (0.5)	59 (0.4)	115 (0.7)	418 (2.1)	1723 (5.5)	408 (1.7)	888 (1.0)
GLP-1RA, Wegovy^®					<5	1035 (4.2)	2157 (2.4)
GLP-1RA, Rybelsus^®			103 (0.6)	762 (3.9)	1406 (4.5)	1848 (7.5)	8886 (9.7)
GLP-1RA, others	277 (4.8)	434 (2.6)	241 (1.5)	204 (1.0)	199 (0.6)	183 (0.7)	1627 (1.8)

Notes: ^aGLP-1RAs approved specifically for weight loss were not included as antidiabetic medication in assessment of presence of T2D.

Abbreviations: HbA1c, glycated hemoglobin; SGLT-2i, sodium-glucose co-transporter-2 inhibitors; DPP-4i, dipeptidyl peptidase 4 inhibitors; GLP-1RA, glucagon-like peptide-1 receptor agonists.

Table 2 Characteristics of patients with a record of diabetes who initiated semaglutide injection (Ozempic^®) from January 2018 to December 2023 or were prevalent users in 2023

	2018	2019	2020	2021	2022	2023	Prevalent users in 2023
Total number of initiators with any diabetes indicator (ever)	5700 (100.0)	16,299 (100.0)	15,224 (100.0)	16,740 (100.0)	21,134 (100.0)	21,512 (100.0)	80,672 (100.0)
Established atherosclerotic cardiovascular disease	1680 (29.5)	4663 (28.6)	4301 (28.3)	4627 (27.6)	5209 (24.7)	5255 (24.4)	22,610 (28.0)
Established kidney disease	807 (14.2)	2151 (13.2)	1852 (12.2)	1771 (10.6)	1761 (8.3)	1618 (7.5)	9522 (11.8)
Established atherosclerotic cardiovascular disease or kidney disease	2149 (37.7)	5881 (36.1)	5289 (34.7)	5538 (33.1)	6212 (29.4)	6185 (28.8)	27,766 (34.4)
Recent suboptimal glycemic control: antidiabetic medication use and HbA1c ≥48 mmol/mol (1 year look-back)	5275 (92.5)	15,111 (92.7)	14,008 (92.0)	14,948 (89.3)	17,433 (82.5)	17,744 (82.5)	55,855 (69.2)
Recent suboptimal glycemic control: antidiabetic medication use and HbA1c ≥53 mmol/mol (1 year look-back)	4925 (86.4)	14,158 (86.9)	13,129 (86.2)	13,656 (81.6)	15,109 (71.5)	14,715 (68.4)	45,943 (57.0)
Number of antidiabetic medications used at baseline
No therapy	43 (0.8)	237 (1.5)	443 (2.9)	819 (4.9)	1902 (9.0)	1799 (8.4)	7578 (9.4)
Monotherapy	656 (11.5)	2817 (17.3)	3671 (24.1)	5045 (30.1)	7591 (35.9)	8430 (39.2)	28,715 (35.6)
Dual therapy	1778 (31.2)	5677 (34.8)	5536 (36.4)	5712 (34.1)	6341 (30.0)	6721 (31.2)	27,715 (34.4)
≥3 medications	3223 (56.5)	7568 (46.4)	5574 (36.6)	5164 (30.9)	5300 (25.1)	4562 (21.2)	16,664 (20.7)
Glycemic control (last measured HbA1c (mmol/mol))
Missing	143 (.)	399 (.)	266 (.)	360 (.)	583 (.)	372 (.)	2952 (.)
<48	564 (10.2)	1130 (7.1)	1028 (6.9)	1491 (9.1)	3151 (15.3)	3434 (16.2)	31,633 (40.7)
48–52	605 (10.9)	1428 (9.0)	1309 (8.8)	1895 (11.6)	3192 (15.5)	4053 (19.2)	13,660 (17.6)
53–57	791 (14.2)	2097 (13.2)	1919 (12.8)	2432 (14.9)	2996 (14.6)	3527 (16.7)	10,623 (13.7)
58–70	1958 (35.2)	5905 (37.1)	5433 (36.3)	5450 (33.3)	6140 (29.9)	5821 (27.5)	14,260 (18.4)
>70	1639 (29.5)	5340 (33.6)	5269 (35.2)	5112 (31.2)	5072 (24.7)	4305 (20.4)	7544 (9.7)

Abbreviation: HbA1c, glycated hemoglobin.