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      Cost-Related Prescription Drug Rationing by Adults With Obesity

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      , MD, MPH 1 , , , BS 2 , , PhD, MPH 3 , , MD, MHS 1 , 4 , 5 , 6 , , PhD, MPH 7 , , MD, MHS 6 , 8
      JAMA Network Open
      American Medical Association

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          Abstract

          This cross-sectional study analyzes data from the National Health Interview Survey to examine the prevalence of cost-related prescription drug rationing by adults with obesity.

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          Most cited references5

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          Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes

          Semaglutide, a glucagon-like peptide-1 receptor agonist, has been shown to reduce the risk of adverse cardiovascular events in patients with diabetes. Whether semaglutide can reduce cardiovascular risk associated with overweight and obesity in the absence of diabetes is unknown.
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            Financial burden, distress, and toxicity in cardiovascular disease.

            Cardiovascular disease (CVD) is a major source of financial burden and distress, which has 3 main domains: (1) psychological distress; (2) cost-related care non-adherence or medical care deferral, and (3) tradeoffs with basic non-medical needs. We propose 4 ways to reduce financial distress in CVD: (1) policymakers can expand insurance coverage and curtail underinsurance; (2) health systems can limit expenditure on low-benefit, high-cost treatments while developing services for high-risk individuals; (3) physicians can engage in shared-decision-making for high-cost interventions, and (4) community-based initiatives can support patients with system navigation and financial coping. Avenues for research include (1) analysis of how healthcare policies affect financial burden; (2) comparative effectiveness studies examining high and low-cost strategies for CVD management; and (3) studying interventions to reduce financial burden, financial coaching, and community health worker integration.
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              US Public’s Perspective on Prescription Drug Costs

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                Author and article information

                Journal
                JAMA Netw Open
                JAMA Netw Open
                JAMA Network Open
                American Medical Association
                2574-3805
                5 November 2024
                November 2024
                5 November 2024
                : 7
                : 11
                : e2433000
                Affiliations
                [1 ]National Clinician Scholars Program, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
                [2 ]Yale School of Medicine, New Haven, Connecticut
                [3 ]Yale Cancer Outcomes, Public Policy, and Effectiveness Research Center, Yale School of Medicine, New Haven, Connecticut
                [4 ]Section of General Internal Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
                [5 ]Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut
                [6 ]Center for Outcomes Research and Evaluation, Yale New Haven Health System, New Haven, Connecticut
                [7 ]Equity Research and Innovation Center, Yale School of Medicine, New Haven, Connecticut
                [8 ]Section of Endocrinology, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
                Author notes
                Article Information
                Accepted for Publication: July 11, 2024.
                Published: November 5, 2024. doi:10.1001/jamanetworkopen.2024.33000
                Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2024 Chen AS et al. JAMA Network Open.
                Corresponding Author: Alissa S. Chen, MD, MPH, Yale School of Medicine, 333 Cedar St, New Haven, CT 06510 ( alissa.chen@ 123456yale.edu ).
                Author Contributions: Dr Chen had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
                Concept and design: Chen, Lipska.
                Acquisition, analysis, or interpretation of data: All authors.
                Drafting of the manuscript: Chen.
                Critical review of the manuscript for important intellectual content: All authors.
                Statistical analysis: Chen, Borden, Canavan.
                Administrative, technical, or material support: Oladele.
                Supervision: Lipska.
                Conflict of Interest Disclosures: Dr Ross reported receiving grants from the Food and Drug Administration, Johnson & Johnson, Medical Device Innovation Consortium, Agency for Healthcare Research and Quality, National Institutes of Health or National Heart, Lung, and Blood Institute, and Arnold Ventures outside the submitted work. Dr Ross was an expert witness at the request of Relator's attorneys, the Greene Law Firm, in a qui tam suit alleging violations of the False Claims Act and Anti-Kickback Statute against Biogen Inc, which was settled in September 2022. Dr Oladele reported receiving grants from the National Institutes of Health during the conduct of the study. Dr Lipska reported receiving personal fees from UpToDate to write and edit content and other fees from Centers for Medicare and Medicaid Services Support to develop and evaluate publicly reported quality measures outside the submitted work. No other disclosures were reported.
                Funding/Support: Dr Chen was funded by grant T32 AG019134 from the National Institute on Aging outside the submitted work. Dr Chen was funded as a Yale National Clinician Scholar.
                Role of the Funder/Sponsor: The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
                Data Sharing Statement: See Supplement 2.
                Article
                zld240147
                10.1001/jamanetworkopen.2024.33000
                11539006
                39499520
                c3b4e733-5947-46e5-872d-bfb137a6d1c8
                Copyright 2024 Chen AS et al. JAMA Network Open.

                This is an open access article distributed under the terms of the CC-BY License.

                History
                : 5 March 2024
                : 11 July 2024
                Categories
                Research
                Research Letter
                Online Only
                Diabetes and Endocrinology

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