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3. Economic Issues in Heart Failure in the United States

Author

Heidenreich, Paul A, Fonarow, Gregg C, Opsha, Yekaterina, Sandhu, Alexander T, Sweitzer, Nancy K, Warraich, Haider J, Chair, HFSA Scientific Statement Committee Members, Butler, Javed, Hsich, Eileen, Pressler, Susan Bennett, Shah, Kevin, Taylor, Kenneth, Sabe, Marwa, and Ng, Tien

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Clinical Sciences, Clinical Research, Clinical Trials and Supportive Activities, Heart Disease - Coronary Heart Disease, Comparative Effectiveness Research, Heart Disease, Health Services, Cost Effectiveness Research, Cardiovascular, 5.1 Pharmaceuticals, 8.2 Health and welfare economics, Health and social care services research, Development of treatments and therapeutic interventions, Good Health and Well Being, Adrenergic beta-Antagonists, Angiotensin Receptor Antagonists, Angiotensin-Converting Enzyme Inhibitors, Cost-Benefit Analysis, Heart Failure, Hospitalization, Humans, Mineralocorticoid Receptor Antagonists, United States, HFSA Scientific Statement Committee Members Chair, Cardiorespiratory Medicine and Haematology, Nursing, Cardiovascular System & Hematology, Cardiovascular medicine and haematology, Clinical sciences
Abstract

The cost of heart failure care is high owing to the cost of hospitalization and chronic treatments. Heart failure treatments vary in their benefit and cost. The cost effectiveness of therapies can be determined by comparing the cost of treatment required to obtain a certain benefit, often defined as an increase in 1 year of life. This review was sponsored by the Heart Failure Society of America and describes the growing economic burden of heart failure for patients and the health care system in the United States. It also provides a summary of the cost effectiveness of drugs, devices, diagnostic tests, hospital care, and transitions of care for patients with heart failure. Many medications that are no longer under patent are inexpensive and highly cost-effective. These include angiotensin-converting enzyme inhibitors, beta-blockers and mineralocorticoid receptor antagonists. In contrast, more recently developed medications and devices, vary in cost effectiveness, and often have high out-of-pocket costs for patients.

Published
2022

7. Association of Chronic Renal Insufficiency with Inhospital Outcomes in Primary Heart Failure Hospitalizations (Insights from the National Inpatient Sample 2004 to 2018)

Author

Minhas, Abdul Mannan Khan, Bhopalwala, Huzefa M., Dewaswala, Nakeya, Ijaz, Sardar Hassan, Khan, Muhammad Shahzeb, Khan, Muhammad Zia, Dani, Sourbha S., Warraich, Haider J., Greene, Stephen J., Edmonston, Daniel L., Lopez, Renato D., Virani, Salim S., Bhopalwala, Adnan, and Fudim, Marat

Published
2023
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12. Medicaid Expansion and Utilization of Antihyperglycemic Therapies

Author

Sumarsono, Andrew, Buckley, Leo F, Machado, Sara R, Wadhera, Rishi K, Warraich, Haider J, Desai, Rishi J, Everett, Brendan M, McGuire, Darren K, Fonarow, Gregg C, Butler, Javed, Pandey, Ambarish, and Vaduganathan, Muthiah

Subjects
Reproductive Medicine, Biomedical and Clinical Sciences, Health Services, Clinical Research, Good Health and Well Being, Adult, Diabetes Mellitus, Type 2, Drug Utilization, Female, Glucagon-Like Peptide-1 Receptor, Humans, Male, Medicaid, Patient Protection and Affordable Care Act, Poverty, Sodium-Glucose Transporter 2 Inhibitors, United States, Medical and Health Sciences, Endocrinology & Metabolism, Biomedical and clinical sciences, Health sciences
Abstract

ObjectiveCertain antihyperglycemic therapies modify cardiovascular and kidney outcomes among patients with type 2 diabetes, but early uptake in practice appears restricted to particular demographics. We examine the association of Medicaid expansion with use of and expenditures related to antihyperglycemic therapies among Medicaid beneficiaries.Research design and methodsWe employed a difference-in-difference design to analyze the association of Medicaid expansion on prescription of noninsulin antihyperglycemic therapies. We used 2012-2017 national and state Medicaid data to compare prescription claims and costs between states that did (n = 25) and did not expand (n = 26) Medicaid by January 2014.ResultsFollowing Medicaid expansion in 2014, average noninsulin antihyperglycemic therapies per state/1,000 enrollees increased by 4.2%/quarter in expansion states and 1.6%/quarter in nonexpansion states. For sodium-glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide 1 receptor agonists (GLP-1RA), quarterly growth rates per 1,000 enrollees were 125.3% and 20.7% for expansion states and 87.6% and 16.0% for nonexpansion states, respectively. Expansion states had faster utilization of SGLT2i and GLP-1RA than nonexpansion states. Difference-in-difference estimates for change in volume of prescriptions after Medicaid expansion between expansion versus nonexpansion states was 1.68 (95% CI 1.09-2.26; P < 0.001) for all noninsulin therapies, 0.125 (-0.003 to 0.25; P = 0.056) for SGLT2i, and 0.12 (0.055-0.18; P < 0.001) for GLP-1RA.ConclusionsUse of noninsulin antihyperglycemic therapies, including SGLT2i and GLP-1RA, increased among low-income adults in both Medicaid expansion and nonexpansion states, with a significantly greater increase in overall use and in GLP-1RA use in expansion states. Future evaluation of the population-level health impact of expanded access to these therapies is needed.

Published
2020

18. Adverse Change in Employment Status After Acute Myocardial Infarction

Author

Warraich, Haider J, Kaltenbach, Lisa A, Fonarow, Gregg C, Peterson, Eric D, and Wang, Tracy Y

Subjects
Health Services and Systems, Biomedical and Clinical Sciences, Clinical Sciences, Health Sciences, Behavioral and Social Science, Clinical Research, Heart Disease - Coronary Heart Disease, Heart Disease, Depression, Mental Health, Patient Safety, Cardiovascular, Good Health and Well Being, Absenteeism, Acute Coronary Syndrome, Aged, Cost of Illness, Drug Costs, Employment, Female, Health Expenditures, Health Status, Humans, Longitudinal Studies, Male, Medication Adherence, Middle Aged, Myocardial Infarction, Percutaneous Coronary Intervention, Platelet Aggregation Inhibitors, Purinergic P2Y Receptor Antagonists, Quality of Life, Registries, Retirement, Return to Work, Risk Assessment, Risk Factors, Time Factors, Treatment Outcome, Unemployment, United States, depression, employment, medication, adherence, myocardial infarction, quality of life, Cardiorespiratory Medicine and Haematology, Public Health and Health Services, Cardiovascular System & Hematology, Cardiovascular medicine and haematology, Public health
Abstract

BACKGROUND:Inability to resume employment after acute myocardial infarction (MI) has important implications for patients. We sought to assess the prevalence of and outcomes associated with adverse change in employment after MI in a national US cohort. METHODS AND RESULTS:The TRANSLATE-ACS study (Treatment with Adenosine Diphosphate Receptor Inhibitors: Longitudinal Assessment of Treatment Patterns and Events after Acute Coronary Syndrome) assessed employment status at baseline and 1 year among 9319 patients with MI (mean age, 60.8 years; SD, 11.3; 27.3% women) enrolled at 233 US hospitals. We defined adverse change in employment as patients working at baseline but working less or not working at 1-year post-MI. In multivariable models, we assessed factors associated with adverse change in employment and its association with patient-reported depression, health status, persistence to evidence-based medications prescribed at discharge, and financial hardship affording medications. Half of the patients (51%; n=4730) were employed at the time of MI. By 1 year, 10% (n=492) of these reported an adverse change in employment, with 3% (n=143) working less and 7% (n=349) no longer working (only 27 of 349 reported retirement). Factors significantly associated with adverse change in employment included a number of unplanned readmissions, postdischarge bleeding complications, hypertension, and smoking. At 1 year, patients with an adverse change in employment were more likely to report depression (Patient Health Questionnaire 2 score >3: 27.4% versus 16.7%), lower health status (mean EuroQoL visual analogue scale: 73 [SD, 17.8] versus 78 [SD, 14.8]), and moderate-extreme financial hardship with medication costs (41.0% versus 28.4%; all P

Published
2018

30. U.S. Food and Drug Administration Updates in Nutrition Labeling: What Clinicians Need to Know.

Author

Warraich, Haider J., Carroll, Laura, McKinnon, Robin A., Kavanaugh, Claudine, and Califf, Robert M.

Subjects
*FOOD labeling, *NUTRITION, *FOOD consumption, *MEDICAL personnel, *MANUFACTURING industries
Abstract

Food labeling can be a highly effective public health tool to promote consumption of healthier foods and to effect positive reformulation by manufacturers. This article summarizes recent efforts by the U.S. Food and Drug Administration to update information found on food labels, including making the information more simple, visible, and reflective of current nutritional science. [ABSTRACT FROM AUTHOR]

Published
2024
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38. Low Rates of Psychotherapy Referrals in Patients With Heart Failure With Depression.

Author

LATIF, ZARA, VAUGHAN, KATHLEEN, MLADENOVIK, VIKTORIA, WARRAICH, HAIDER, and MUKAMAL, KENNETH

Abstract

Depression is common among patients with heart failure (HF) and can impact patients' outcomes. In this study, we evaluated the rates of psychotherapy referrals for patients with HF with depression. Using the National Ambulatory Medical Care Survey from 2008 to 2018, we examined visits for patients with depression and concurrent HF or coronary artery disease. We estimated the likelihood of referral for psychotherapy using survey weights to provide nationally representative estimates. Among 1797 visits for patients with HF or coronary artery disease and depression, only 9.4% (95% confidence interval 7.2%–12.2%) were referred for psychotherapy, including mental health counseling and stress management. Rates of referral were lowest among patients with depression and HF at 7.5% (95% confidence interval 4.1%–13.2%). The odds of referral decreased over the years from 2008 to 2018 (odds ratio per additional year 0.87, 95% confidence interval 0.77–0.98, P =.022), with referral rates in 2008 of 12.8% compared with 4.8% in 2018. In this nationally representative study of ambulatory visits, patients with HF and depression were referred for psychotherapy in only 7.5% of visits and referral rates have decreased over the years. Magnifying the value of psychotherapy and increasing referral rates are essential steps to improve care for patients with HF with depression. [ABSTRACT FROM AUTHOR]

Published
2024
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40. List of Contributors

Author

Acosta, Anna M., primary, Acuin, Jose M., additional, Adam, Rodney D., additional, Afroze, Farzana, additional, Ahmed, Nadia, additional, Ahmed, Sabeena, additional, Ahmed, Tahmeed, additional, Ahmed, A.M. Shamsir, additional, Ali, S. Asad, additional, Ali, Ibne K., additional, Alroy, Karen A., additional, Ananthakrishnan, Ashwin N., additional, Ansong, Daniel, additional, Anstead, Gregory M., additional, Appleby, Laura J., additional, Armah, George E., additional, Aronson, Naomi E., additional, Aston, Stephen J., additional, Barnett, Elizabeth D., additional, Bartelt, Luther A., additional, Bates, Imelda, additional, Bausch, Daniel G., additional, Beadling, Charles W., additional, Beeching, Nicholas J., additional, Bennish, Michael L., additional, Bern, Caryn, additional, Bernstein, Wendy B., additional, Bird, Brian H., additional, Bloom, Allyson K., additional, Bodeker, Gerard, additional, Boyer Chammard, Timothée, additional, Bradsher, Robert W., additional, Brooker, Simon J., additional, Brooks, W. Abdullah, additional, Brouqui, Philippe, additional, Brown, Michael, additional, Brown, Michael R., additional, Broyles, Laura N., additional, Bruschi, Fabrizio, additional, Bundy, Donald A.P., additional, Burton, Matthew, additional, Cabrera-Sosa, Luis, additional, Callahan, Michael V., additional, Carapetis, Jonathan R., additional, Cardemil, Cristina V., additional, Carrol, Enitan D., additional, Caswell, Rachel, additional, Caumes, Eric, additional, Cavalheiro, Ana P., additional, Chan, Abner L., additional, Charunwatthana, Prakaykaew, additional, Checkley, Anna M., additional, Chen, Lin H., additional, Chher, Tepirou, additional, Chiong, Charlotte M., additional, Chisti, M. Jobayer, additional, Christiani, David C., additional, Clark, Taryn N., additional, Connor, Bradley A., additional, Conway, Devin J., additional, Cooper, Philip J., additional, Cope, Jennifer R., additional, Coughlin, R. Richard, additional, Coulibaly, Yaya I., additional, Coyle, Christina M., additional, Crozier, Ian, additional, Cunliffe, Nigel A., additional, Cupido, Blanche, additional, Curren, Emily J., additional, Danta, Mark, additional, Day, Nicholas P.J., additional, Debboun, Mustapha, additional, DeFraites, Robert F., additional, Dekumyoy, Paron, additional, del Castillo, Maria, additional, den Hoed, Caroline M., additional, de Silva, Nilanthi, additional, Deye, Gregory, additional, Dillingham, Rebecca A., additional, Drancourt, Michel, additional, Durward, Callum S., additional, Eddleston, Michael, additional, El-Kamary, Samer S., additional, Elshaboury, Ramy H., additional, Endtz, Hubert P., additional, Endy, Timothy P., additional, Fang, Shona C., additional, Fawzi, Wafaie, additional, Feasey, Nicholas A., additional, Field, Vanessa K., additional, Fischer, Marc, additional, Forsyth, Kevin, additional, Fournier, Pierre-Edouard, additional, Friedlander, Arthur M., additional, Furin, Jennifer J., additional, Gandhi, Ronak G., additional, Garcia, Hector H., additional, Garcia, Lynne S., additional, Geretti, Anna Maria, additional, Gikas, Achilleas, additional, Gilman, Robert H., additional, Giri, Sidhartha, additional, Gkika, Meropi, additional, Gordon, Melita A., additional, Gosselin, Richard A., additional, Gotuzzo, Eduardo, additional, Gould, Carolyn V., additional, Graeff-Teixeira, Carlos, additional, Graham, Stephen M., additional, Grant, Alison D., additional, Graybill, John R., additional, Graz, Bertrand, additional, Green, Stephen T., additional, Griffiths, Jeffrey K., additional, Griffiths, Michael J., additional, Gryseels, Bruno, additional, Gubler, Duane J., additional, Guhadasan, Rathi, additional, Hall, Aron J., additional, Hamer, Davidson H., additional, Hand, Robert M., additional, Harley, David, additional, Harris, Jason B., additional, Hassall, Oliver, additional, Hay, Roderick J., additional, Hickey, Patrick, additional, Hill, David R., additional, Hills, Susan L., additional, Hobdell, Martin H., additional, Hochberg, Natasha S., additional, Hopkins, Donald R., additional, Hossain, M. Iqbal, additional, Hotez, Peter J., additional, Howard, Cynthia R., additional, Hu, Victor, additional, Hung, Chien-Ching, additional, Islam, Munirul, additional, Iturriza-Gómara, Miren, additional, Joekes, Elizabeth, additional, Johnston, Victoria, additional, Jose, Jo-Ann, additional, Junghanss, Thomas, additional, Kamgno, Joseph, additional, Kampondeni, Sam, additional, Kang, Gagandeep, additional, Kazanjian, Powel, additional, Keshtkar-Jahromi, Maryam, additional, Keshtkar-Jahromi, Marzieh, additional, Keystone, Jay S., additional, Kim, Arthur Y., additional, Kim, Sung-Han, additional, King, Christopher L., additional, Kittitrakul, Chatporn, additional, Kleine, Christian, additional, Klion, Amy D., additional, Knight, Richard, additional, Koren, Michael, additional, Kottilil, Shyamasundaran, additional, Krause, Peter J., additional, Krishna, Sanjeev, additional, Kuhn, Jens H., additional, Kuipers, Ernst J., additional, LaBeaud, Angelle D., additional, Labra, Patrick John P., additional, Lalloo, David G., additional, Lambert, Saba, additional, Lanternier, Fanny, additional, LaRocque, Regina C., additional, Last, Anna, additional, Lawrenson, John, additional, Le, Thuy, additional, Lee, Keun Hwa, additional, Lewis, David A., additional, Libraty, Daniel H., additional, Lo, Nathan C., additional, Lockwood, Diana N.J., additional, Lockwood, Stephen J., additional, Lommerse, Kinke, additional, López-Vélez, Rogelio, additional, Lortholary, Olivier, additional, Mabey, David, additional, Magill, Alan J., additional, Maguiña, Ciro P., additional, Manji, Hadi, additional, Marks, Michael, additional, Maurin, Max, additional, Mayaud, Philippe, additional, Mayosi, Bongani M., additional, M'baya, Bridon, additional, McCarthy, Matthew W., additional, McCartney, Daniel, additional, McCormick, Joseph B., additional, McKew, Stephen, additional, McLellan, Susan L.F., additional, McMinn, Peter C., additional, Mertz, Gregory, additional, Milner, Danny A., additional, Molyneux, Elizabeth M., additional, Montgomery, Susan P., additional, Moonah, Shannon, additional, Moss, William J., additional, Murrell, K. Darwin, additional, Nanda, Neha, additional, Navarro, Eileen E., additional, Ndayizeye, Leonard, additional, Neafie, Ronald C., additional, Negroni, Ricardo, additional, Nelson, Ann M., additional, Newton, Paul N., additional, Nichol, Stuart T., additional, Norman, Francesca F., additional, Nunes, Marcio R.T., additional, Nutman, Thomas B., additional, Nyirenda, Tonney S., additional, Ochoa, Theresa J., additional, O'Farrell, Nigel, additional, Olayemi, Edeghonghon, additional, Oldfield, Edward C., additional, Omidian, Zahra, additional, Ordaya, Eloy E., additional, Paddock, Christopher D., additional, Paessler, Slobodan, additional, Papanikolaou, Ilias C., additional, Paris, Luc, additional, Parry, Christopher M., additional, Patel, Pragna, additional, Peacock, Sharon J., additional, Peeling, Rosanna W., additional, Persson, Hans, additional, Phillips, Jonathan J., additional, Phillips, Richard O., additional, Poovorawan, Kittiyod, additional, Powers, Ann M., additional, Qamar, Farah Naz, additional, Qureshi, Sonia, additional, Rabe, Ingrid B., additional, Rahman, Atif, additional, Rahmati, Elham, additional, Raizes, Elliot, additional, Ramalho-Ortigao, Marcelo, additional, Raoult, Didier, additional, Rein, Michael F., additional, Retik, Alan B., additional, Reynes, Jean-Marc, additional, Rhatigan, Joseph J., additional, Rickard, Jennifer, additional, Riddle, Mark S., additional, Rimoin, Anne W., additional, Riviello, Robert, additional, Robert, Leon L., additional, Rodrigues, Ema G., additional, Rodriguez, Rubens, additional, Ronald, Allan R., additional, Rosenthal, Benjamin M., additional, Rosmarin, David, additional, Ryan, Edward T., additional, Saavedra, Arturo, additional, Schiaffino, Francesca, additional, Schumacher, Sandra K., additional, Sejvar, James J., additional, Sethi, Aisha, additional, Seung, Kwonjune J., additional, Seydel, Karl B., additional, Shah, Melisa M., additional, Shakoor, Sadia, additional, Shankar, Anuraj H., additional, Sharp, Trueman W., additional, Shin, Sonya S., additional, Shirley, Debbie-Ann, additional, Silachamroon, Udomsak, additional, Smith, Catherine C., additional, Snelling, Thomas L., additional, Solomon, Tom, additional, Staat, Mary Allen, additional, Staples, J. Erin, additional, Steiger, Samantha N., additional, Stewart, Robert C., additional, Stich, August, additional, Strickman, Daniel, additional, Suh, Kathryn N., additional, Suhrbier, Andreas, additional, Sutcliffe, Catherine G., additional, Tappe, Dennis, additional, Taylor, Terrie E., additional, Thanh, Nguyen Tat, additional, Thanh, Nguyen Thi, additional, Thwaites, C. Louise, additional, Thwaites, Guy E., additional, Tiwari, Tejpratap S.P., additional, Tsenempi, Xenia A., additional, Turner, Angus W., additional, van den Broek, Nynke R., additional, van Doorn, H. Rogier, additional, Van Sickels, Nicholas J., additional, Vannier, Edouard, additional, Varda, Briony K., additional, Vasconcelos, Pedro F.C., additional, Vega-López, Francisco, additional, Vietri, Nicholas J., additional, Vinetz, Joseph M., additional, Visvesvara, Govinda S., additional, Vyas, Keyur S., additional, Walsh, Thomas J., additional, Wansbrough-Jones, Mark H., additional, Warraich, Haider J., additional, Warrell, David A., additional, Warrell, Mary J., additional, Watt, George, additional, Wattanagoon, Yupaporn, additional, Watthanakulpanich, Dorn, additional, Weaver, Scott C., additional, Weil, Ana A., additional, Weiss, Louis M., additional, White, Nicholas J., additional, Whitty, Christopher J.M., additional, Wilson, Mary E., additional, Xavier, Ramnik J., additional, Xiao, Lihua, additional, Yoon, In-Kyu, additional, Yu, Hongjie, additional, and Zaidi, Anita K.M., additional

Published
2020
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44. Ask a Doctor: Can gum disease cause other health problems?

Author

Warraich, Haider

Subjects
Gum diseases -- Prevention -- Care and treatment -- Complications and side effects, Gingivitis -- Prevention -- Care and treatment -- Complications and side effects, General interest, News, opinion and commentary
Abstract

Byline: Haider Warraich and MD Q.Can gum disease cause other health problems? A. Medicine and dentistry are often seen as separate fields, leading some to believe that the mouth is [...]

Published
2023

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