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What We’re Reading: Emergency Care Prices Vary; Drug Shortages at Record High; Asthma Medication Access Difficulties


Prices for care at hospital trauma centers vary across hospitals; drug shortages reached a record high during the first quarter of 2024; although 3 of the biggest makers of asthma inhalers pledged to cap out-of-pocket costs for some US patients at $35, these do not apply to daily inhalers used by the youngest kids with asthma.

Study Shows Emergency Care Prices Vary 16-Fold

A recent study published in JAMA Surgery found that prices for initiating care at trauma centers vary across hospitals, according to Modern Healthcare. To analyze cash and negotiated prices associated with emergency care, the researchers used hospital price transparency data released in relation to a law that went into effect in 2021. They found that across 761 hospitals, prices associated with preparing doctors and other personnel for trauma cases varied 16-fold in 2023. More specifically, the median cash price for trauma activation fees among level 1 trauma centers was 25% lower than the median rate hospitals negotiated with insurers in 2023, meaning that patients with insurance at times paid more than patients without coverage. Consequently, the researchers advocated for the government to pass legislation that gives patients the option to pay the cash price if the negotiated price is higher; this is already the case in states like Tennessee and Texas.

Drug Shortages Surpass Record High Last Seen in 2014

Drug shortages reached a record high during the first quarter of 2024, according to USA Today. Data provided by the American Society of Health-System Pharmacists and the University of Utah Drug Information Service reported that supplies of 323 drugs were running low during the first quarter of 2024, surpassing the 2014 high of 320. The drug shortage has affected both basic and life-saving drugs, from chemotherapy medications to attention-deficit/hyperactivity disorder (ADHD) medications. Other drugs affected include the injectable drug semaglutide (Wegovy and Ozempic) for treating obesity and diabetes. In response, the Federal Trade Commission and HHS announced in February that they will investigate whether drug wholesalers and companies that buy medicines for health care providers are partly to blame for the shortages.

Price Caps Do Not Apply to Asthma Medications Young Children Need, Doctors Say

Although 3 of the biggest makers of asthma inhalers pledged to cap out-of-pocket costs for some US patients at $35, these do not apply to daily inhalers used by younger kids with asthma, according to CNN, putting them in danger of flare-ups and emergency visits. The 3 inhaler options for children are ciclesonide (Alvesco), mometasone furoate (Asmanex), and fluticasone, the authorized generic version of GSK’s Flovent that was taken off the market earlier this year. These inhalers are made by Covis Pharma, Organon, and Prasco Laboratories, respectively, all of which are not among the companies that made the $35 pledges on asthma drugs. Consequently, these inhalers have become increasingly expensive and hard to find. To help, some insurers have provided coverage options. For example, CVS Caremark allows patients 6 years and under to receive generic Flovent without submitting a formulary exception. However, it is not always clear at the point of prescribing which pharmacy benefit manager a patient has, resulting in hurdles like filling out paperwork to obtain coverage. Also, even with coverage, out-of-pocket costs can still be high.

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