Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jun 1;4(6):e2113963.
doi: 10.1001/jamanetworkopen.2021.13963.

Increases in Anti-infective Drug Prices, Subsequent Prescribing, and Outpatient Costs

Junsoo Lee  1   2 , Heesoo Joo  1 , Brian A Maskery  1 , Jonathan D Alpern  3 , Chanhyun Park  4   5 , Michelle Weinberg  1 , William M Stauffer  1   3
Affiliations

Increases in Anti-infective Drug Prices, Subsequent Prescribing, and Outpatient Costs

Junsoo Lee et al. JAMA Netw Open. .

Abstract

This cross-sectional study examines the association of prices for drugs to treat hookworm and pinworm with prescribing and prescription-filling behaviors and total outpatient treatment costs.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Disclosures: Dr Alpern reported receiving grants from Arnold Ventures outside the submitted work. Dr Stauffer reported receiving an honorarium from Fishawack Health/Emergent BioSolutions and royalties from UpToDate outside the submitted work. No other disclosures were reported.

Figures

Figure 1.
Figure 1.. Proportions of Patients Treated With Standard-of-Care (SOC) Prescription Drugs and Mean Outpatient Visit and Drug Costs
Numbers of patients with hookworm, pinworm, and Clostridioides difficile who were treated (and not treated) with SOC prescription drugs are as follows. For hookworm, the numbers are 267 (360) patients in 2010 to 2011, 206 (413) patients in 2012 to 2013, 156 (385) patients in 2014 to 2015, and 219 (572) patients in 2016 to 2018. For pinworm, the numbers are 4283 (1007) patients in 2010, 4915 (1286) patients in 2011, 4207 (2121) patients in 2012, 1917 (2810) patients in 2013, 1551 (3300) patients in 2014, 1322 (2849) patients in 2015, 1218 (3076) patients in 2016, 1234 (2940) patients in 2017, and 807 (2064) patients in 2018. For C difficile, the numbers are 2383 (1070) patients in 2010, 3393 (1320) patients in 2011, 4057 (1461) patients in 2012, 3663 (1418) patients in 2013, 4010 (1501) patients in 2014, 4188 (1403) patients in 2015, 4317 (1411) patients in 2016, 3625 (1136) patients in 2017, and 2502 (740) patients in 2018. The changes over time were tested by using the comparison between 2010 and 2018 data. Among the samples, the proportions of female patients were 52.2% for hookworm, 62.5% for pinworm, and 64.5% for C difficile. Mean ages for patients with hookworm, pinworm, and C difficile were 32.7, 13.1, and 42.0 years, respectively. Patients older than 65 years were excluded from the analysis to avoid issues with Medicare coinsurance payments, as mentioned in the eAppendix in the Supplement. Error bars denote 95% CIs.
Figure 2.
Figure 2.. Proportions of Patients Treated With Standard-of-Care (SOC) Drugs or Non-SOC Prescription Drugs and Mean SOC and Patient Out-of-Pocket (OOP) Drug Costs
The changes over time were estimated by using the comparison between 2010 and 2018 data. For hookworm and pinworm, the fractions filling prescriptions for ivermectin are shown. However, ivermectin is inferior to albendazole and mebendazole and is not considered an SOC treatment.Error bars denote 95% CIs.
See this image and copyright information in PMC

References

    1. Joo H, Lee J, Maskery BA, et al. . The effect of drug pricing on outpatient payments and treatment for three soil-transmitted helminth infections in the United States, 2010-2017. Am J Trop Med Hyg. 2021;104(5):1851-1857. doi:10.4269/ajtmh.20-1452 - DOI - PMC - PubMed
    1. Truven Health Analytics/IBM Watson Health . Active ingredient: albendazole, mebendazole—Red Book online. IBM Micromedex. Published 2021. Accessed January 8, 2021. http://www.micromedexsolutions.com
    1. Clarke NE, Doi SAR, Wangdi K, Chen Y, Clements ACA, Nery SV. Efficacy of anthelminthic drugs and drug combinations against soil-transmitted helminths: a systematic review and network meta-analysis. Clin Infect Dis. 2019;68(1):96-105. doi:10.1093/cid/ciy423 - DOI - PubMed
    1. McDonald LC, Gerding DN, Johnson S, et al. . Clinical practice guidelines for Clostridium difficile infection in adults and children: 2017 update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clin Infect Dis. 2018;66(7):e1-e48. doi:10.1093/cid/cix1085 - DOI - PMC - PubMed
    1. Johnson S, Louie TJ, Gerding DN, et al. ; Polymer Alternative for CDI Treatment (PACT) investigators . Vancomycin, metronidazole, or tolevamer for Clostridium difficile infection: results from two multinational, randomized, controlled trials. Clin Infect Dis. 2014;59(3):345-354. doi:10.1093/cid/ciu313 - DOI - PubMed

MeSH terms

Substances