The High Cost of Prescription Drugs in the United States

Kesselheim, Aaron S.; Avorn, Jerry; Sarpatwari, Ameet

doi:10.1001/jama.2016.11237

Cited by 484 publications

(437 citation statements)

References 94 publications

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“…On average, per capita spending on prescription drugs in the United States is $858, compared with an average of $400 in 19 other industrialized countries. 6 Patients' opinion of the efficacy of drug therapy in CVD prevention is often inflated multifold. 7,8 It has been estimated that high-risk patients have a < 5% chance of benefiting from cardioprotective drugs within the next 5 years.…”

Section: Introductionmentioning

confidence: 99%

A defined, plant‐based diet utilized in an outpatient cardiovascular clinic effectively treats hypercholesterolemia and hypertension and reduces medications

Najjar

Moore

Montgomery

2018

Clinical Cardiology

102

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BackgroundCardiovascular disease (CVD) is a major economic burden in the United States. CVD risk factors, particularly hypertension and hypercholesterolemia, are typically treated with drug therapy. Five‐year efficacy of such drugs to prevent CVD is estimated to be 5%. Plant‐based diets have emerged as effective mitigators of these risk factors.HypothesisThe implementation of a defined, plant‐based diet for 4 weeks in an outpatient clinical setting may mitigate CVD risk factors and reduce patient drug burden.MethodsParticipants consumed a plant‐based diet consisting of foods prepared in a defined method in accordance with a food‐classification system. Participants consumed raw fruits, vegetables, seeds, and avocado. All animal products were excluded from the diet. Participant anthropometric and hemodynamic data were obtained weekly for 4 weeks. Laboratory biomarkers were collected at baseline and at 4 weeks. Medication needs were assessed weekly. Data were analyzed using paired‐samples t tests and 1‐way repeated‐measures ANOVA.ResultsSignificant reductions were observed for systolic (−16.6 mmHg) and diastolic (−9.1 mmHg) blood pressure (P < 0.0005), serum lipids (P ≤ 0.008), and total medication usage (P < 0.0005). Other CVD risk factors, including weight (P < 0.0005), waist circumference (P < 0.0005), heart rate (P = 0.018), insulin (P < 0.0005), glycated hemoglobin (P = 0.002), and high‐sensitivity C‐reactive protein (P = 0.001) were also reduced.ConclusionA defined, plant‐based diet can be used as an effective therapeutic strategy in the clinical setting to mitigate cardiovascular risk factors and reduce patient drug burden.

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Section: Introductionmentioning

confidence: 99%

A defined, plant‐based diet utilized in an outpatient cardiovascular clinic effectively treats hypercholesterolemia and hypertension and reduces medications

Najjar

Moore

Montgomery

2018

Clinical Cardiology

102

View full text Add to dashboard Cite

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“…Academic detailing through evidence-based information by specially trained noncommercial outreach educators to physician offices has been shown to be effective in more than 60 randomized controlled trials and could be targeted to specific locations or practice characteristics from future studies such as this. 9 Furthermore, with the emergence of health care systems, there are opportunities for information feedback where physicians could be rewarded for prescribing drugs optimally. …”

Section: Discussionmentioning

confidence: 99%

Using Drug Prescribing Patterns to Identify Stewards of Cost-Conscious Care

Wingrove¹,

Liaw²,

Petterson³

et al. 2017

J Am Board Fam Med

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Purpose: To characterize family physicians (FPs) who are stewards of care by consistently prescribing omeprazole over esomeprazole.Methods: Cross-sectional analysis of physicians prescribing omeprazole or esomeprazole under Medicare Part D in 2014.Results: There was a regional trend with 49% of Western FPs but only 6% of Southern FPs rarely prescribing esomeprazole. Physicians had increased odds of being a steward if they worked with a care coordinator (P < .001), at a patient-centered medical home (P < .001), or in a large practice (P < .001).Conclusions

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“…However, while the pharmaceutical and biotech industries may assume considerable risk, they have also consistently been among the most profitable sectors of the U.S. economy [10]. Moreover, data show that large pharmaceutical corporations invest just 10 to 20 percent of their revenue in research and development [11]. Additionally, an analysis of corporate filings indicates that between 2005 and 2010 drug companies spent 19 times more on promotion and marketing of new drugs than on research [12].…”

Section: Factors Accounting For the High Prices And Pharmaceutical Comentioning

confidence: 99%