Module D: prescribers

Exploration notebook, module D: existing outputs only, no new analysis

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Part D reflects diabetes and other covered uses, not obesity-brand adoption. Primary care wrote 55.8% of 2024 claims.

Volume, specialty, concentration

The top volume decile of prescribers wrote 41.4% of 2024 claims; the bottom five deciles together 13.9%.

data_year specialty_group claims prescribers claims_share_pct prescriber_share_pct
2018 Primary care physicians 1406352 38145 54.09 67.75
2018 Nurse practitioners and physician assistants 484077 11827 18.62 21.00
2018 Endocrinology 640147 4523 24.62 8.03
2018 Cardiology 11077 247 0.43 0.44
2018 Other 58403 1564 2.25 2.78
2019 Primary care physicians 1964544 47427 53.99 66.26
2019 Nurse practitioners and physician assistants 745326 16899 20.48 23.61
2019 Endocrinology 834365 4840 22.93 6.76
2019 Cardiology 15421 321 0.42 0.45
2019 Other 79048 2090 2.17 2.92
data_year prescribers gini top10_share_pct top1_share_pct
2018 56306 0.529 43.214 11.450
2019 71577 0.541 44.149 11.719
2020 87244 0.546 44.262 11.642
2021 103850 0.551 44.301 11.633
2022 129244 0.548 43.471 11.330
2023 171805 0.551 42.291 10.723
2024 199822 0.551 41.368 10.392
decile prescribers claims min_claims median_claims max_claims share_of_prescribers_pct share_of_claims_pct cumulative_share_from_top_pct
1 19982 241028 241028 241028 241028 10 1.23 100.00
2 19982 331342 331342 331342 331342 10 1.69 98.77
3 19982 495186 495186 495186 495186 10 2.53 97.08
4 19982 701161 701161 701161 701161 10 3.58 94.55
5 19983 957914 957914 957914 957914 10 4.89 90.97
6 19982 1288370 1288370 1288370 1288370 10 6.58 86.08
7 19982 1721331 1721331 1721331 1721331 10 8.79 79.51
8 19982 2338487 2338487 2338487 2338487 10 11.94 70.72
9 19982 3411968 3411968 3411968 3411968 10 17.42 58.78
10 19983 8104702 8104702 8104702 8104702 10 41.37 41.37

Stacked bars of the share of Part D incretin claims by specialty group, 2018 to 2024. In 2024 primary care physicians wrote 55.8 percent, nurse practitioners and physician assistants 27.7 percent, endocrinology 12.7 percent, cardiology 1.0 percent, other 2.8 percent.

Specialty mix

Left: Lorenz curves of Part D incretin claims across prescribers for 2018, 2021 and 2024, bowing below the equality line. Right: the share of claims by the top 10 percent of prescribers, 43.2 percent in 2018 and 41.4 percent in 2024, and by the top 1 percent, 11.4 and 10.4 percent.

Concentration

Bar chart of the share of 2024 Part D incretin claims written by each tenth of prescribers ranked by volume. The top decile wrote 41.4 percent of claims and the bottom five deciles together 13.9 percent, against 10 percent each if volume were equal.

Share of claims by prescriber volume decile

Adoption

data_year specialty_group prescribers with_mounjaro share_pct
2022 Primary care physicians 79099 902 1.14
2022 Nurse practitioners and physician assistants 38718 546 1.41
2022 Endocrinology 5462 481 8.81
2022 Cardiology 976 23 2.36
2022 Other 4989 82 1.64
2023 Primary care physicians 99975 24662 24.67
2023 Nurse practitioners and physician assistants 56509 13941 24.67
2023 Endocrinology 5725 3926 68.58
2023 Cardiology 1879 443 23.58
2023 Other 7717 1410 18.27
2024 Primary care physicians 112323 55453 49.37
2024 Nurse practitioners and physician assistants 69303 32348 46.68
2024 Endocrinology 5881 5230 88.93
2024 Cardiology 2930 1101 37.58
2024 Other 9385 3076 32.78

Lines of the share of Part D incretin prescribers with any tirzepatide row by specialty group, 2022 to 2024. Overall the share rises from 1.6 percent in 2022 to 48.6 percent in 2024.

Tirzepatide adoption

Paired horizontal bars of the share of 2024 Part D claims by prescriber specialty group for Wegovy and Ozempic. Cardiology wrote 14.5 percent of Wegovy claims and 1.2 percent of Ozempic claims.

Wegovy and Ozempic by specialty

Segments (exploratory)

The pre-specified rule gave a two-segment split of new versus continuing prescribers; the five-segment solution is exploratory, with stability beside each segment.

cluster prescribers share_of_prescribers_pct claims share_of_claims_pct median_claims median_growth_log share_new_2024_pct mean_tirz_share_pct dominant_specialty dominant_pct mean_jaccard share_bootstraps_above_0.75 volume tirz spec_short segment segment_id
5 60392 30.223 13055482 66.639 160 0.389 0.000 31.081 Primary care physicians 77.320 0.722 0.42 high-volume some tirzepatide primary care A: high-volume primary care, some tirzepatide A
4 40328 20.182 2677846 13.668 56 0.309 0.000 13.897 Nurse practitioners and physician assistants 96.201 0.558 0.32 mid-volume some tirzepatide NP and PA B: mid-volume NP and PA, some tirzepatide B
1 45773 22.907 2292330 11.701 44 0.219 0.000 2.758 Primary care physicians 92.504 0.691 0.34 mid-volume little or no tirzepatide primary care C: mid-volume primary care, little or no tirzepatide C
3 43345 21.692 1308779 6.680 20 3.045 100.000 5.975 Primary care physicians 45.791 0.865 0.86 lower-volume little or no tirzepatide primary care D: lower-volume primary care, little or no tirzepatide, new… D
2 9984 4.996 257052 1.312 18 2.565 64.022 93.303 Nurse practitioners and physician assistants 52.624 0.552 0.34 lower-volume mostly tirzepatide NP and PA E: lower-volume NP and PA, mostly tirzepatide, new in 2024 E

Dot plot of 5 prescriber segments across seven profile measures: median 2024 claims, median growth, tirzepatide share of claims, share new in 2024, share of all prescribers, share of all claims and stability. A: high-volume primary care, some tirzepatide wrote 66.6 percent of claims; B: mid-volume NP and PA, some tirzepatide wrote 13.7 percent of claims; C: mid-volume primary care, little or no tirzepatide wrote 11.7 percent of claims; D: lower-volume primary care, little or no tirzepatide, new in 2024 wrote 6.7 percent of claims; E: lower-volume NP and PA, mostly tirzepatide, new in 2024 wrote 1.3 percent of claims

Exploratory segments

Part of the project report; every number comes from analysis/outputs/key_numbers.csv. Public aggregate data; no company affiliation or endorsement.