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7 results on '"Giuriato, Mia"'

1. Changes in Prescription Drug and Health Care Use Over 9 Years After the Large Drug Price Increase for Colchicine

Author

Ly, Dan P, Giuriato, Mia A, and Song, Zirui

Subjects
Clinical Research, Evaluation of treatments and therapeutic interventions, 6.1 Pharmaceuticals, Good Health and Well Being, Humans, Male, Female, Adolescent, Colchicine, Allopurinol, Gout Suppressants, Prescription Drugs, Cohort Studies, Retrospective Studies, Gout, Adrenal Cortex Hormones, Delivery of Health Care, Clinical Sciences, Opthalmology and Optometry, Public Health and Health Services
Abstract

ImportancePrescription drug prices are a leading concern among patients and policy makers. There have been large and sharp price increases for some drugs, but the long-term implications of large drug price increases remain poorly understood.ObjectiveTo examine the association of the large 2010 price increase in colchicine, a common treatment for gout, with long-term changes in colchicine use, substitution with other drugs, and health care use.Design, setting, and participantsThis retrospective cohort study examined MarketScan data from a longitudinal cohort of patients with gout with employer-sponsored insurance from 2007 through 2019.ExposuresThe US Food and Drug Administration's discontinuation of lower-priced versions of colchicine from the market in 2010.Main outcomes and measuresMean price of colchicine; use of colchicine, allopurinol, and oral corticosteroids; and emergency department (ED) and rheumatology visits for gout in year 1 and over the first decade of the policy (through 2019) were calculated. Data were analyzed between November 16, 2021, and January 17, 2023.ResultsA total of 2 723 327 patient-year observations were examined from 2007 through 2019 (mean [SD] age of patients, 57.0 [13.8] years; 20.9% documented as female; 79.1% documented as male). The mean price per prescription of colchicine increased sharply from $11.25 (95% CI, $11.23-$11.28) in 2009 to $190.49 (95% CI, $190.07-$190.91) in 2011, a 15.9-fold increase, with the mean out-of-pocket price increasing 4.4-fold from $7.37 (95% CI, $7.37-$7.38) to $39.49 (95% CI, $39.42-$39.56). At the same time, colchicine use declined from 35.0 (95% CI, 34.6-35.5) to 27.3 (95% CI, 26.9-27.6) pills per patient in year 1 and to 22.6 (95% CI, 22.2-23.0) pills per patient in 2019. Adjusted analyses showed a 16.7% reduction in year 1 and a 27.0% reduction over the decade (P

Published
2023

4. Firearm Injuries In Children And Adolescents: Health And Economic Consequences Among Survivors And Family Members

Author

Song, Zirui, Zubizarreta, José R., Giuriato, Mia, Koh, Katherine A., and Sacks, Chana A.

Abstract

More US children and adolescents today die from firearms than any other cause, and many more sustain firearm injuries and survive. The clinical and economic impact of these firearm injuries on survivors and family members remains poorly understood. Using 2007–21 commercial health insurance claims data, we studied 2,052 child and adolescent survivors compared to 9,983 matched controls who did not incur firearm injuries, along with 6,209 family members of survivors compared to 29,877 matched controls, and 265 family members of decedents compared to 1,263 matched controls. Through one year after firearm injury, child and adolescent survivors experienced a 117 percent increase in pain disorders, a 68 percent increase in psychiatric disorders, and a 144 percent increase in substance use disorders relative to the controls. Survivors’ health care spending increased by an average of $34,884—a 17.1-fold increase—with 95 percent paid by insurers or employers. Parents of survivors experienced a 30–31 percent increase in psychiatric disorders, with 75 percent more mental health visits by mothers, and 5–14 percent reductions in mothers’ and siblings’ routine medical care. Family members of decedents experienced substantially larger 2.3- to 5.3-fold increases in psychiatric disorders, with at least 15.3-fold more mental health visits among parents. Firearm injuries in youth have notable health implications for the whole family, along with large effects on societal spending.

Published
2023
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7. Economic and Clinical Impact of Covid-19 on Provider Practices in Massachusetts

Author

Song, Zirui, Giuriato, Mia, Lillehaugen, Timothy, Altman, Wayne, Horn, Daniel M., Phillips, Russell S., Barnett, Katherine Gergen, Bitton, Asaf, Edgman-Levitan, Susan, Choi, Elisa, Hattis, Paul, McKee, M. Diane, and Auerbach, David

Subjects
Commentary
Abstract

A survey of health care providers reveals significant adverse effects on the ability to serve patients and sustain the practice. Without policy solutions and financial support, practice sales and closures may be imminent., Summary A survey developed through a partnership of clinicians, researchers, and public and private entities in Massachusetts was hosted by Harvard Medical School. Between May 20 and July 9, 2020, respondents from 398 practices shared details on the revenue and expense implications of the novel coronavirus, as well as insights into the personal impact Covid-19 is having. More than 60% of practices reported they would cut salaries of providers or employees, cut services or other operating expenses, and furlough or lay off more employees without additional financial assistance, with a roughly 40% likelihood of following through. Consolidation, selling, or closing the practice were reported by 20%–40% of practices, driven by independent practices such as primary care (60% noted closure at 21% likelihood). The authors include policy actions that may mitigate the harm to access to care.

Published
2020

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