The 340B Drug Pricing Program incentivizes healthcare providers to increase medication use. It does this by allowing certain safety-net hospitals and clinics to purchase outpatient drugs at considerable discounts from manufacturers but be reimbursed at full price by payers. Yet, previous literature has left largely unstudied how the 340B program influences physician prescribing behavior. In this paper, I provide evidence of physician agency among 340B providers in the treatment of breast cancer. I leverage the staggered diffusion of the program to identify the impact of 340B participation on prescribing behavior and patient outcomes. Physicians who join the 340B program increase the share of patients who receive pharmaceutical treatments and increase the intensity of per-patient prescribing. I also find significant increases in prescribing medications that are not included in clinical treatment recommendations and medications to treat side effects. Despite more intensive treatment use, I find no statistically significant change in survival.
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http://dx.doi.org/10.1016/j.jhealeco.2025.102971 | DOI Listing |
J Opioid Manag
March 2025
Abt Global, LLC, Cambridge, Mas-sachusetts. ORCID: https://orcid.org/0000-0003-3391-2041.
Objective: The Six Building Blocks: A Team-Based Approach to Improving Opioid Management in Primary Care (6BBs) program provides a roadmap for improving the management of patients on opioid therapy for chronic pain. The goal of this project was to evaluate the How-to-Implement Toolkit (Toolkit) for clinics to independently implement the 6BBs without a practice facilitator.
Methods: Eight healthcare organizations with 62 clinics participated in the program.
Transplantation
March 2025
Scientific Registry of Transplant Recipients (SRTR), Minneapolis, MN.
Background: Kidney transplant offers better outcomes and reduced costs compared with chronic dialysis. However, racial and ethnic disparities in access to kidney transplant persist despite efforts to expand access to transplant and improve the equity of deceased donor allocation. Our objective was to evaluate after listing the association of race and ethnicity with access to deceased donor kidney transplant (DDKT) after changes to the allocation system in 2014.
View Article and Find Full Text PDFFundam Clin Pharmacol
April 2025
Département de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi), Unité de Recherche Clinique PSL-CFX, CIC-1901, Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, équipe PEPITES, AP-HP, Hôpital Pitié Salpêtrière, Paris, France.
Context: After observing increased sudden death risk associated with domperidone use, the European Medicines Agency (EMA) imposed usage restrictions in 2014, limiting age (≤60 years), daily dose (≤30 mg/day), and duration (≤7 days). Nausea commonly occurs as an adverse effect of dopaminergic drugs in Parkinson's disease (PD) patients, with few alternative anti-emetic options. This study aimed to assess domperidone prescription patterns in French PD patients.
View Article and Find Full Text PDFMedEdPORTAL
March 2025
Chief Medical Officer, Southern California American Indian Health Center.
Introduction: The United States has a trust responsibility to provide health care to members of the 574 federally recognized American Indian and Alaska Native (AI/AN) Tribes and Villages through the Indian Health Service, an agency tasked with promoting AI/AN health and cultural connectedness. Despite the presence of a comprehensive health care system in 37 states, physicians and allied health professionals receive minimal health professional education regarding the sociocultural factors affecting AI/AN health. This module addresses the underrepresentation of AI/AN health professional curricula and promotes a greater understanding of AI/AN health determinants and cultural constructions of health for individuals with limited exposure to these topics.
View Article and Find Full Text PDFLancet
March 2025
McGill International TB Centre, Montreal, QC, Canada; Department of Medicine, McGill University, Montreal, QC, Canada; McGill International TB Centre & WHO Collaborating Centre in TB Research, Montreal Chest Institute, Research Institute of the McGill University Health Centre, Montreal, QC, Canada. Electronic address:
Tuberculosis is a leading cause of death globally. Given the airborne transmission of tuberculosis, anybody can be infected, but people in high-incidence settings are more exposed. Risk of progression to disease is higher in the first years after infection, and in people with undernourishment, immunosuppression, or who smoke, drink alcohol, or have diabetes.
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