vida: extract claims from 2025-glp1-discontinuation-reinitiation-jama-open

- Source: inbox/queue/2025-glp1-discontinuation-reinitiation-jama-open.md
- Domain: health
- Claims: 0, Entities: 0
- Enrichments: 3
- Extracted by: pipeline ingest (OpenRouter anthropic/claude-sonnet-4.5)

Pentagon-Agent: Vida <PIPELINE>

domains/health/glp1-long-term-persistence-ceiling-14-percent-year-two.md

@@ -30,3 +30,10 @@ Cost is a major driver of discontinuation: 14% of former GLP-1 users stopped due
 **Source:** Cell/Med 2025, The Societal Implications of Using GLP-1 Receptor Agonists for the Treatment of Obesity
 
 Cell/Med 2025 connects low persistence rates to the sustainability concern: chronic use model + high prices + discontinuation effects = fiscal unsustainability at scale. The paper notes need to 'consider acceptability over long term and implications for weight stigma,' suggesting that persistence barriers are not just clinical or financial but also social. The equity inversion compounds this: those with highest need face both highest discontinuation rates (per existing KB claims on wealth-stratified access) and lowest initial access, creating a double barrier to population-level impact.
+
+
+## Supporting Evidence
+
+**Source:** JAMA Network Open 2025, PMC11786232
+
+46.5% of T2D patients and 64.8% of obesity-only patients discontinued within one year, with obesity indication showing 39% worse adherence than T2D. This stratification by indication confirms the persistence ceiling is worse for obesity patients, the primary target population for cost impact projections.

domains/health/lower-income-patients-show-higher-glp-1-discontinuation-rates-suggesting-affordability-not-just-clinical-factors-drive-persistence.md

@@ -1,31 +1,15 @@
 ---
 type: claim
 domain: health
-description: "Income level correlates with GLP-1 discontinuation rates in commercially insured populations, indicating that cost-sharing and affordability barriers drive adherence as much as clinical factors like side effects or insufficient weight loss"
+description: Income level correlates with GLP-1 discontinuation rates in commercially insured populations, indicating that cost-sharing and affordability barriers drive adherence as much as clinical factors like side effects or insufficient weight loss
 confidence: experimental
 source: "Journal of Managed Care & Specialty Pharmacy, Real-world Persistence and Adherence to GLP-1 RAs Among Obese Commercially Insured Adults Without Diabetes, 2024-08-01"
 created: 2026-03-11
-related_claims:
-  - divergence-glp1-economics-chronic-cost-vs-low-persistence
-related:
-- federal-budget-scoring-methodology-systematically-undervalues-preventive-interventions-because-10-year-window-excludes-long-term-savings
-- glp-1-multi-organ-protection-creates-compounding-value-across-kidney-cardiovascular-and-metabolic-endpoints
-- pcsk9-inhibitors-achieved-only-1-to-2-5-percent-penetration-despite-proven-efficacy-demonstrating-access-mediated-pharmacological-ceiling
-- GLP-1 cost evidence accelerates value-based care adoption by proving that prevention-first interventions generate net savings under capitation within 24 months
-- Is the GLP-1 economic problem unsustainable chronic costs or wasted investment from low persistence?
-reweave_edges:
-- federal-budget-scoring-methodology-systematically-undervalues-preventive-interventions-because-10-year-window-excludes-long-term-savings|related|2026-03-31
-- glp-1-multi-organ-protection-creates-compounding-value-across-kidney-cardiovascular-and-metabolic-endpoints|related|2026-03-31
-- pcsk9-inhibitors-achieved-only-1-to-2-5-percent-penetration-despite-proven-efficacy-demonstrating-access-mediated-pharmacological-ceiling|related|2026-03-31
-- GLP-1 cost evidence accelerates value-based care adoption by proving that prevention-first interventions generate net savings under capitation within 24 months|related|2026-04-04
-- GLP-1 access structure is inverted relative to clinical need because populations with highest obesity prevalence and cardiometabolic risk face the highest barriers creating an equity paradox where the most effective cardiovascular intervention will disproportionately benefit already-advantaged populations|supports|2026-04-04
-- GLP-1 access follows systematic inversion where states with highest obesity prevalence have both lowest Medicaid coverage rates and highest income-relative out-of-pocket costs|supports|2026-04-14
-- Is the GLP-1 economic problem unsustainable chronic costs or wasted investment from low persistence?|related|2026-04-17
-supports:
-- GLP-1 access structure is inverted relative to clinical need because populations with highest obesity prevalence and cardiometabolic risk face the highest barriers creating an equity paradox where the most effective cardiovascular intervention will disproportionately benefit already-advantaged populations
-- GLP-1 access follows systematic inversion where states with highest obesity prevalence have both lowest Medicaid coverage rates and highest income-relative out-of-pocket costs
-sourced_from:
-- inbox/archive/health/2024-08-01-jmcp-glp1-persistence-adherence-commercial-populations.md
+related_claims: ["divergence-glp1-economics-chronic-cost-vs-low-persistence"]
+related: ["federal-budget-scoring-methodology-systematically-undervalues-preventive-interventions-because-10-year-window-excludes-long-term-savings", "glp-1-multi-organ-protection-creates-compounding-value-across-kidney-cardiovascular-and-metabolic-endpoints", "pcsk9-inhibitors-achieved-only-1-to-2-5-percent-penetration-despite-proven-efficacy-demonstrating-access-mediated-pharmacological-ceiling", "GLP-1 cost evidence accelerates value-based care adoption by proving that prevention-first interventions generate net savings under capitation within 24 months", "Is the GLP-1 economic problem unsustainable chronic costs or wasted investment from low persistence?", "lower-income-patients-show-higher-glp-1-discontinuation-rates-suggesting-affordability-not-just-clinical-factors-drive-persistence", "glp1-long-term-persistence-ceiling-14-percent-year-two", "glp-1-persistence-drops-to-15-percent-at-two-years-for-non-diabetic-obesity-patients-undermining-chronic-use-economics", "glp1-access-follows-systematic-inversion-highest-burden-states-have-lowest-coverage-and-highest-income-relative-cost", "wealth-stratified-glp1-access-creates-disease-progression-disparity-with-lowest-income-black-patients-treated-at-13-percent-higher-bmi"]
+reweave_edges: ["federal-budget-scoring-methodology-systematically-undervalues-preventive-interventions-because-10-year-window-excludes-long-term-savings|related|2026-03-31", "glp-1-multi-organ-protection-creates-compounding-value-across-kidney-cardiovascular-and-metabolic-endpoints|related|2026-03-31", "pcsk9-inhibitors-achieved-only-1-to-2-5-percent-penetration-despite-proven-efficacy-demonstrating-access-mediated-pharmacological-ceiling|related|2026-03-31", "GLP-1 cost evidence accelerates value-based care adoption by proving that prevention-first interventions generate net savings under capitation within 24 months|related|2026-04-04", "GLP-1 access structure is inverted relative to clinical need because populations with highest obesity prevalence and cardiometabolic risk face the highest barriers creating an equity paradox where the most effective cardiovascular intervention will disproportionately benefit already-advantaged populations|supports|2026-04-04", "GLP-1 access follows systematic inversion where states with highest obesity prevalence have both lowest Medicaid coverage rates and highest income-relative out-of-pocket costs|supports|2026-04-14", "Is the GLP-1 economic problem unsustainable chronic costs or wasted investment from low persistence?|related|2026-04-17"]
+supports: ["GLP-1 access structure is inverted relative to clinical need because populations with highest obesity prevalence and cardiometabolic risk face the highest barriers creating an equity paradox where the most effective cardiovascular intervention will disproportionately benefit already-advantaged populations", "GLP-1 access follows systematic inversion where states with highest obesity prevalence have both lowest Medicaid coverage rates and highest income-relative out-of-pocket costs"]
+sourced_from: ["inbox/archive/health/2024-08-01-jmcp-glp1-persistence-adherence-commercial-populations.md"]
 ---
 
 # Lower-income patients show higher GLP-1 discontinuation rates suggesting affordability not just clinical factors drive persistence
@@ -90,4 +74,10 @@ Relevant Notes:
 - [[SDOH interventions show strong ROI but adoption stalls because Z-code documentation remains below 3 percent and no operational infrastructure connects screening to action]]
 
 Topics:
-- domains/health/_map
+- domains/health/_map
+
+## Supporting Evidence
+
+**Source:** JAMA Network Open 2025
+
+Income >$80K associated with lower discontinuation rates. History of GI medication (9% more likely to discontinue) and psychiatric medication (12% more likely) also predicted discontinuation, suggesting both affordability and tolerability barriers operate simultaneously.

inbox/archive/health/2025-glp1-discontinuation-reinitiation-jama-open.md

@@ -7,9 +7,12 @@ date: 2025-01-01
 domain: health
 secondary_domains: []
 format: peer-reviewed study
-status: unprocessed
+status: processed
+processed_by: vida
+processed_date: 2026-04-27
 priority: high
 tags: [glp-1, discontinuation, adherence, obesity, T2D, real-world, JAMA, persistence, weight-regain, reinitiation]
+extraction_model: "anthropic/claude-sonnet-4.5"
 ---
 
 ## Content