Surging prices spur decline in heart drug use, Cleveland Clinic research finds

Physicians used significantly lower amounts of two heart drugs in hospital settings following major price spikes on the medications, according to Cleveland Clinic research published Thursday in The New England Journal of Medicine.

For the study, researchers examined utilization data for nitroprusside and isoproterenol in 47 hospitals from 2012 to 2015. During this time period, the price of nitroprusside jumped from $27.46 to $880.88, while isoproterenol skyrocketed from $26.20 to $1,790.11. Researchers also examined utilization data for two other heart drugs with stable pricing — nitroglycerin and dobutamine — to serve as control variables.

From 2012 to 2015, patients treated with nitroprusside dropped 53 percent and those treated with isoproterenol fell 35 percent. In contrast, the amount of patients treated with nitroglycerin or dobutamine increased by 118 percent and 7 percent, respectively.

"In public testimony, it had been stated that these price increases would not decrease patient access or utilization of these two critical drugs, both of which have been used for decades in patient care," said lead author Umesh Khot, MD, Cleveland Clinic's vice chairman of cardiovascular medicine. "However, our research shows that these price hikes are not benign. Further research will determine if there has been any effect on patient outcomes, but it's clear that utilization has been impacted."

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