Patient Out‐of‐Pocket Costs Following the Availability of Biosimilar Versions of Infliximab DOI
Kimberly Feng, Aaron S. Kesselheim, Massimiliano Russo

et al.

Clinical Pharmacology & Therapeutics, Journal Year: 2022, Volume and Issue: 113(1), P. 90 - 97

Published: Oct. 13, 2022

After market exclusivity ends for biologic drugs, biosimilars-follow-on versions made by other manufacturers-can compete with lower prices. Biosimilars have modestly reduced prescription drug spending US payers, but it is unclear whether patients directly experienced any savings. In this study we assessed availability of biosimilar infliximab was associated out-of-pocket (OOP) costs, using claims from a national data set commercially insured 2014 to 2018. We used two-part models, adjusting patient demographics, clinical characteristics, insurance plan type, and calendar month. Compared the reference biologic, there no difference in percentage OOP costs (30.1% vs. 30.8%; adjusted odds ratio (aOR) 0.98, 95% confidence interval (CI), 0.84-1.15, P = 0.84) or average nonzero cost (median $378 $538, mean (aMR) 0.97, CI, 0.80-1.18, 0.77). The after competition (30.7% 35.0%, aOR 0.96, 0.94-0.99, 0.003), increased $534 $520, aMR 1.04, 1.01-1.07, 0.004). Thus, early did not improve affordability patients. Policymakers need better assure that translates these medications.

Language: Английский

Chronic Disease Prevalence in the US: Sociodemographic and Geographic Variations by Zip Code Tabulation Area DOI Creative Commons
Gabriel A. Benavidez, Whitney E. Zahnd, Peiyin Hung

et al.

Preventing Chronic Disease, Journal Year: 2024, Volume and Issue: 21

Published: Feb. 29, 2024

Preventing Chronic Disease (PCD) is a peer-reviewed electronic journal established by the National Center for Prevention and Health Promotion. PCD provides an open exchange of information knowledge among researchers, practitioners, policy makers, others who strive to improve health public through chronic disease prevention.

Language: Английский

Citations

24
Cost-effectiveness of Sodium-Glucose Cotransporter-2 Inhibitors for the Treatment of Heart Failure With Preserved Ejection Fraction DOI Open Access
Laura Cohen, Nicolás Isaza, Inmaculada Hernandez

et al.

JAMA Cardiology, Journal Year: 2023, Volume and Issue: 8(5), P. 419 - 419

Published: March 4, 2023

Adding a sodium-glucose cotransporter-2 inhibitor (SGLT2-I) to standard-of-care treatment in patients with heart failure preserved ejection fraction (HFpEF) reduces the risk of composite outcome worsening or cardiovascular mortality, but cost-effectiveness US HFpEF is uncertain.

Language: Английский

Citations

38
The association between cost sharing, prior authorization, and specialty drug utilization: A systematic review DOI
Wisam Ismail, Matthew J. Witry, Julie M. Urmie

et al.

Journal of Managed Care & Specialty Pharmacy, Journal Year: 2023, Volume and Issue: 29(5), P. 449 - 463

Published: April 30, 2023

BACKGROUND: Specialty drugs are identified by high monthly costs and complexity of administration. Payers use utilization management strategies, including prior authorization separate tiers with higher cost sharing, to control spending. These strategies can negatively impact patients' health outcomes through treatment initiation delays, medication abandonment, nonadherence. OBJECTIVE: To examine the effect patient sharing on specialty drug delay utilization. METHODS: We conducted a literature search in period between February 2021 April 2022 using PubMed for articles published English without restriction date publication. included research papers as exposure variables outcome variable. Studies were reviewed 2 independent reviewers relevant information from eligible studies was extracted standardized form approved reviewers. Review papers, opinion pieces, projects data excluded. RESULTS: Forty-four this review after screening exclusions, 9 35 sharing. Patients lower via support programs experienced adherence, fewer days fill prescriptions, discontinuation rates. Similar noted patients low-income subsidy programs. Increasing above $100 associated up 75% abandonment rate certain drugs. This increased level also rates odds. At same time, decreasing out-of-pocket However, inconsistent results possession ratio (MPR) proportion covered (PDC) reported. Some reported negative association MPR PDC; however, PDC cancer did not decrease costs. Significant delays prescription when needed. CONCLUSIONS: Higher levels reduce increasing while generally persistence. Similarly, that increase In contrast, had an bidirectional PDC. Prior caused but its effects varied. More is needed long-term outcomes.

Language: Английский

Citations

28
Patient Out-of-Pocket Costs for Biologic Drugs After Biosimilar Competition DOI Creative Commons
Kimberly Feng, Massimiliano Russo, Luca Maini

et al.

JAMA Health Forum, Journal Year: 2024, Volume and Issue: 5(3), P. e235429 - e235429

Published: March 29, 2024

Biologic drugs account for a growing share of US pharmaceutical spending. Competition from follow-on biosimilar products (subsequent versions that have no clinically meaningful differences the original biologic) has led to modest reductions in health care spending, but these savings may not translate lower out-of-pocket (OOP) costs patients.

Language: Английский

Citations

15
Assessing the Effect of the Medicare Part D Redesign DOI
Rachel E. Sachs, Richard G. Frank

JAMA, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 8, 2025

This Viewpoint focuses on the Manufacturer Discount Program, identifying 4 key themes of interest to policymakers that may be affected by its Part D redesign.

Language: Английский

Citations

1
The Inflation Reduction Act and Out-of-Pocket Drug Costs for Medicare Beneficiaries With Cardiovascular Disease DOI Creative Commons
Dhruv S. Kazi, Colette DeJong, Randi Chen

et al.

Journal of the American College of Cardiology, Journal Year: 2023, Volume and Issue: 81(21), P. 2103 - 2111

Published: May 1, 2023

Language: Английский

Citations

21
Financial toxicity: A practical review for gynecologic oncology teams to understand and address patient-level financial burdens DOI Creative Commons
Margaret Liang,

Ross Harrison,

Emeline M. Aviki

et al.

Gynecologic Oncology, Journal Year: 2023, Volume and Issue: 170, P. 317 - 327

Published: Feb. 7, 2023

Language: Английский

Citations

19
CRISPR in Public Health: The Health Equity Implications and Role of Community in Gene-Editing Research and Applications DOI
Andrew M. Subica

American Journal of Public Health, Journal Year: 2023, Volume and Issue: 113(8), P. 874 - 882

Published: Aug. 1, 2023

CRISPR (clustered regularly interspaced short palindromic repeats) is a Nobel Prize-winning technology that holds significant promise for revolutionizing the prevention and treatment of human disease through gene editing. However, CRISPR's public health implications remain relatively uncertain underdiscussed because (1) targeting genetic factors alone will have limited influence on population health, (2) minority populations (racial/ethnic, sexual gender)-who bear nation's greatest burdens-historically suffer unequal benefits from emerging care innovations tools. This article introduces its potential (e.g., improving virus surveillance, curing diseases pose problems such as sickle cell anemia) while outlining several major ethical practical threats to equity. includes minorities' grave underrepresentation in genomics research, which may lead less effective accepted tools therapies these groups, their anticipated access care. Informed by principles fairness, justice, equitable access, ensuring editing promotes rather than diminishes equity require meaningful centering engagement patients gene-editing research using community-based participatory approaches. (Am J Public Health. 2023;113(8):874-882. https://doi.org/10.2105/AJPH.2023.307315).

Language: Английский

Citations

18
Prescription Drug Spending in Fee-for-Service Medicare, 2008-2019 DOI
Stacie B. Dusetzina, Haiden A. Huskamp, Xuanzi Qin

et al.

JAMA, Journal Year: 2022, Volume and Issue: 328(15), P. 1515 - 1515

Published: Oct. 18, 2022

Importance Prescription drug spending is a topic of increased interest to the public and policymakers. However, prior assessments have been limited by focusing on retail (Part D–covered drugs), omitting clinician-administered B–covered) spending, or all fee-for-service Medicare beneficiaries, regardless their enrollment into prescription coverage. Objective To estimate proportion health care contributed drugs assess for prescriptions. Design, Setting, Participants Descriptive, serial, cross-sectional analysis 20% random sample beneficiaries in United States from 2008 2019 who were continuously enrolled Parts A (hospital), B (medical), D (prescription drug) benefits, not Advantage. Exposure Calendar year. Main Outcomes Measures Net D–covered) drugs; (spending Part B–covered drugs) as percentage total per-capita spending. adjusted inflation postsale rebates (for drugs). Results There 3 201 284 A, B, 4 502 718 2019. In 2019, had mean (SD) age 71.7 (12.0) years, documented sex was female 57.7%, 69.5% no low-income subsidies. Total $16 345 $20 117 Comparing with $7106 (95% CI, $7084-$7128) vs $7120 $7098-$7141), $720 $713-$728) $1641 $1629-$1653), nondrug $5113 $5105-$5122) $6702 $6692-$6712), net $3122 $3117-$3127) $3477 $3466-$3489). The annual attributed 24.0% 27.2% estimated discounts. Conclusions Relevance represented approximately 27% among D, even after accounting rebates.

Language: Английский

Citations

23
Added Therapeutic Benefit of Top-Selling Brand-name Drugs in Medicare DOI
Alexander C. Egilman, Benjamin N. Rome, Aaron S. Kesselheim

et al.

JAMA, Journal Year: 2023, Volume and Issue: 329(15), P. 1283 - 1283

Published: April 18, 2023

Importance The Inflation Reduction Act of 2022 authorizes Medicare to negotiate prices top-selling drugs based on several factors, including therapeutic benefit compared with existing treatment options. Objective To determine the added 50 brand-name in 2020, as assessed by health technology assessment (HTA) organizations Canada, France, and Germany. Design, Setting, Participants In this cross-sectional study, publicly available ratings, US Food Drug Administration documents, Part B D prescription drug spending dashboards were used single-source 2020 assess their ratings through 2021. Main Outcomes Measures Ratings from HTA bodies Germany categorized high (moderate or greater) low (minor no) benefit. Each was rated its most favorable rating across countries, indications, subpopulations, dosage forms. We use prerebate postrebate (ie, net) between vs Results Forty-nine (98%) received an at least 1 country; 22 36 (61%) a 34 47 France (72%), 17 29 (59%). Across 27 (55%) had rating, accounting for $19.3 billion annual estimated net spending, 35% 11% total 2020. Compared those benefit, more beneficiaries (median 387 149 44 869) lower per beneficiary $992 $32 287). Conclusions Relevance Many national When negotiating these drugs, should ensure they are not priced higher than reasonable alternatives.

Language: Английский

Citations

15