TY - JOUR
T1 - Improving the affordability of prescription medications for people with chronic respiratory disease an official American thoracic society policy statement
AU - Patel, Minal R.
AU - Gerald, Joe K.
AU - Gerald, Lynn B.
AU - Press, Valerie G.
AU - Barnes, Teresa B.A.
AU - Blake, Kathryn
AU - Brown, Lee K.
AU - Costello, Richard W.
AU - Crim, Courtney
AU - Forshag, Mark
AU - Gershon, Andrea S.
AU - Goss, Christopher H.
AU - Han, Meilan K.
AU - Lee, Todd A.
AU - Moore, Nuala
AU - Sweet, Stuart
N1 - Funding Information:
Author Disclosures: K.B. received research support from GlaxoSmithKline. L.K.B. served as a consultant for Considine and Associates; received author royalties from Decision Support in Medicine and UpToDate; and served as coeditor for Current Opinion in Pulmonary Medicine and Sleep Medicine Clinics. R.W.C. received research support from Aerogen and GlaxoSmithKline; served as a speaker for Novartis, Teva, Aerogen, and GlaxoSmithKline; and holds intellectual property on a patent for a method to quantify adherence and a patent for the use of acoustics to assess adherence. C.C. is an employee of and owns stocks in GlaxoSmithKline. M.F. is an employee of and speaker for GlaxoSmithKline; owns stocks in GlaxoSmithKline, Grifols, and Pfizer; and holds intellectual property on a patent owned by Grifols. C.H.G. served as a grant reviewer for the Cystic Fibrosis Foundation and Gilead; received research support from the Cystic Fibrosis Foundation, European Commission, and Vertex Pharmaceuticals; served on a data and safety monitoring board for Novartis; and is serving as U.S. lead in a phase 2 trial of a novel therapy for cystic fibrosis for Boehringer Ingelheim. M.K.H. served as a consultant for AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, and Novartis; received research support from Novartis and Sunovion; and served as a speaker for Novartis. T.A.L. received research support from Gilead and the Institute for Clinical and Economic Review; and received personal fees from Eisai Co. and Merck. S.S. received research support from Genentech. M.R.P., J.K.G., L.B.G., V.G.P., T.B., and A.S.G. reported no relationships with relevant commercial interests.
Funding Information:
Supported by the American Thoracic Society.
Publisher Copyright:
Copyright © 2018 by the American Thoracic Society.
PY - 2018/12/1
Y1 - 2018/12/1
N2 - Background: Mounting evidence indicates that out-of-pocket costs for prescription medications, particularly among low- and middle-income patients with chronic diseases, are imposing financial burden, reducing medication adherence, and worsening health outcomes. This problem is exacerbated by a paucity of generic alternatives for prevalent lung diseases, such as asthma and chronic obstructive pulmonary disease, as well as high-cost medicines for rare diseases, such as cystic fibrosis. Affordability and access challenges are especially salient in the United States, as citizens of many other countries pay lower prices for and have greater access to prescription medications. Methods: The American Thoracic Society convened a multidisciplinary committee comprising experts in health policy pharmacoeconomics, behavioral sciences, and clinical care, along with individuals providing industry and patient perspectives. The report and its recommendation were iteratively developed over a year of in-person, telephonic, and electronic deliberation. Results: The committee unanimously recommended the establishment of a publicly funded, politically independent, impartial entity to systematically draft evidence-based pharmaceutical policy recommendations. The goal of this entity would be to generate evidence and action steps to ensure people have equitable and affordable access to prescription medications, to maximize the value of public and private pharmaceutical expenditures on health, to support novel drug development within a market-based economy, and to preserve clinician and patient choice regarding personalized treatment. An immediate priority is to examine the evidence and make recommendations regarding the need to have essential medicines with established clinical benefit from each drug class in all Tier 1 formularies and propose recommendations to reduce barriers to timely generic drug availability. Conclusions: By making explicit, evidence-based recommendations, the entity can support the establishment of coherent national policies that expand access to affordable medications, improve the health of patients with chronic disease, and optimize the use of public and private resources.
AB - Background: Mounting evidence indicates that out-of-pocket costs for prescription medications, particularly among low- and middle-income patients with chronic diseases, are imposing financial burden, reducing medication adherence, and worsening health outcomes. This problem is exacerbated by a paucity of generic alternatives for prevalent lung diseases, such as asthma and chronic obstructive pulmonary disease, as well as high-cost medicines for rare diseases, such as cystic fibrosis. Affordability and access challenges are especially salient in the United States, as citizens of many other countries pay lower prices for and have greater access to prescription medications. Methods: The American Thoracic Society convened a multidisciplinary committee comprising experts in health policy pharmacoeconomics, behavioral sciences, and clinical care, along with individuals providing industry and patient perspectives. The report and its recommendation were iteratively developed over a year of in-person, telephonic, and electronic deliberation. Results: The committee unanimously recommended the establishment of a publicly funded, politically independent, impartial entity to systematically draft evidence-based pharmaceutical policy recommendations. The goal of this entity would be to generate evidence and action steps to ensure people have equitable and affordable access to prescription medications, to maximize the value of public and private pharmaceutical expenditures on health, to support novel drug development within a market-based economy, and to preserve clinician and patient choice regarding personalized treatment. An immediate priority is to examine the evidence and make recommendations regarding the need to have essential medicines with established clinical benefit from each drug class in all Tier 1 formularies and propose recommendations to reduce barriers to timely generic drug availability. Conclusions: By making explicit, evidence-based recommendations, the entity can support the establishment of coherent national policies that expand access to affordable medications, improve the health of patients with chronic disease, and optimize the use of public and private resources.
KW - Chronic respiratory disease
KW - Medication affordability
KW - Pharmaceuticals
KW - Prescriptions
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U2 - 10.1164/rccm.201810-1865ST
DO - 10.1164/rccm.201810-1865ST
M3 - Article
C2 - 30601674
AN - SCOPUS:85057788017
VL - 198
SP - 1367
EP - 1374
JO - American Journal of Respiratory and Critical Care Medicine
JF - American Journal of Respiratory and Critical Care Medicine
SN - 1073-449X
IS - 11
ER -