Looming Crisis of Financial Toxicity in Neurologic Drug Pricing

Smith, A Gordon

doi:10.1212/wnl.0000000000201725

Cited by 6 publications

(2 citation statements)

References 5 publications

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“…He highlighted an additional point that both drugs also showed benefit in fatigue scores, and he raises a number of important issues about cost, and whether these drugs should be used early to potentially induce remission, combined with other drugs, or restricted to refractory MG. Regarding the neurologist's role in considering cost in use of these new drugs, the editorial by Gordon Smith 15 regarding "financial toxicity in neurologic drug pricing" is worth a read.…”

Section: Clinical Neuromuscular Diseasementioning

confidence: 99%

What Is in the Neuromuscular Junction Literature?

Lacomis

2023

Journal of Clinical Neuromuscular Disease

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This update covers several articles on diagnosis and misdiagnosis of myasthenia gravis (MG), the role of complement in MG, and then an impressive number of recent treatment trials. There is a negative study on any corticosteroid-sparing effect of intravenous immunoglobulin. A number of positive studies are reviewed. Open-label extension studies of phase 3 trials showed benefit regarding quality of life with efgartigimod and in functional measures with ravulizumab. The phase 3 RAISE trial of zilucoplan, a self-administered complement C5 inhibitor, is covered as well as the MyCarinG trial of rozanolixizumab. The notion of using fast-acting therapies early in the course of MG is addressed. The last sections center on MG and Lambert–Eaton myasthenic syndrome as a consequence of immune checkpoint inhibitor therapy.

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Section: Clinical Neuromuscular Diseasementioning

confidence: 99%

What Is in the Neuromuscular Junction Literature?

Lacomis

2023

Journal of Clinical Neuromuscular Disease

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“…"Since 2013, the concept of financial toxicity has gained significant popularity in the oncology literature and has been adopted in other specialties, such as neurology. 3 The reasons for this are understandable. Clinicians are familiar with the notion of unintended and sometimes serious noxious side effects of treatments.…”

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confidence: 99%

Words Matter: Unintended Side Effects of “Financial Toxicity”

Blackstone,

Daly

2023

Journal of the National Comprehensive Cancer Network

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H igh out-of-pocket costs of treatment in the United States are a major driver of health disparities. The financial burdens associated with medical care are frequently referred to in the literature as "financial toxicity." This term was popularized after articles by Zafar and Abernethy in 2013 highlighted the growing out-of-pocket costs borne by patients with cancer. 1,2 They describe financial toxicity as consisting of both "objective financial burden" and the subjective distress resulting from that burden. The authors attribute increasing costs to 4 factors: "an aging populace, more patients with access to treatment, innovation, and overutilization."Since 2013, the concept of financial toxicity has gained significant popularity in the oncology literature and has been adopted in other specialties, such as neurology. 3 The reasons for this are understandable. Clinicians are familiar with the notion of unintended and sometimes serious noxious side effects of treatments. Chemotherapeutic agents powerful enough to slow or eradicate cancerous cells often are just as powerful in damaging healthy tissue. Thus, explanation of potential toxicity is routinely included in discussions with patients about recommended treatment. "Financial toxicity" is a useful idiom that encourages clinicians to screen for, identify, and attempt to manage treatment-induced financial problems just as they do for other treatment-related toxicities. However, this choice of language may obscure rather than illuminate causes of the problem and our responsibility to work toward solutions.

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