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Article ; Online: Brief Report: Financial Burden of Toxoplasmosis Encephalitis Treatment at a Safety Net Hospital.

Bogard, Sherri N / Lee, James T / Patel, Manish / Kempker, Russell R

Journal of acquired immune deficiency syndromes (1999)

2022 Volume 91, Issue 3, Page(s) 276–279

Abstract: Background: Although the price increase of pyrimethamine in 2015 received heavy media coverage, there are little data regarding specific implications to hospitals and the total costs of treating inpatients with toxoplasmosis encephalitis (TE).: ... ...

Abstract	Background: Although the price increase of pyrimethamine in 2015 received heavy media coverage, there are little data regarding specific implications to hospitals and the total costs of treating inpatients with toxoplasmosis encephalitis (TE). Methods: Using average drug wholesale costs, we estimated the inpatient drug costs of TE drugs 3 years prepyrimethamine and postpyrimethamine price increase in August 2015. The drug regimens and total doses were determined through retrospective chart review of patients living with HIV who received treatment for TE while inpatient during this period. Results: The 3-year pre-increase TE drug costs for 66 admissions were estimated at $50,310 compared with a total drug cost of $1,026,006 for 61 admissions postincrease. Pyrimethamine made up 98% of the drug costs postincrease, compared with 57% pre-increase. Pyrimethamine-based regimens were the most frequently used throughout the study period. Conclusions: The price increase of pyrimethamine in 2015 led to a substantial and unnecessary financial burden to hospitals. This required health care systems to shift valuable resources to continue to provide medications to a vulnerable patient population. There has been more focus on providing high-value care in recent years. Our study highlights the need for further examination of pharmaceutical companies' arbitrary determination of medication costs and how they contribute to patient care.
MeSH term(s)	Encephalitis ; Financial Stress ; HIV Infections/drug therapy ; Humans ; Pharmaceutical Preparations ; Pyrimethamine/therapeutic use ; Retrospective Studies ; Safety-net Providers ; Toxoplasmosis, Cerebral/chemically induced ; Toxoplasmosis, Cerebral/drug therapy
Chemical Substances	Pharmaceutical Preparations ; Pyrimethamine (Z3614QOX8W)
Language	English
Publishing date	2022-10-14
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	645053-2
ISSN	1944-7884 ; 1077-9450 ; 0897-5965 ; 0894-9255 ; 1525-4135
ISSN (online)	1944-7884 ; 1077-9450
ISSN	0897-5965 ; 0894-9255 ; 1525-4135
DOI	10.1097/QAI.0000000000003054
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: High Mortality among Older Patients Hospitalized with COVID-19 during the First Pandemic Wave

medRxiv

Abstract: Background: Understanding the local epidemiology, including mortality, of COVID-19 is important for guiding optimal mitigation strategies such as vaccine implementation, need for study of more effective treatment, and redoubling of focused infection ... ...

Abstract	Background: Understanding the local epidemiology, including mortality, of COVID-19 is important for guiding optimal mitigation strategies such as vaccine implementation, need for study of more effective treatment, and redoubling of focused infection control measures. Methods: A retrospective observational cohort study design was utilized. We included adult patients diagnosed in the hospital or emergency department with COVID-19 from March 8, 2020 through May 17, 2020 at Grady Memorial Hospital (Atlanta, GA). Medical chart data abstraction was performed to collect clinical, laboratory and outcome data. Death, defined as inpatient mortality or discharge to hospice, was the primary outcome. Results: Among 360 persons with laboratory-confirmed COVID-19, 50% were ≥ 60 years, and most (80%) were Black and had a BMI ≥25 kg/m2 (64%). A total of 53 patients (15%) had an outcome of death with the majority (n=46, 88%) occurring in persons ≥ 60 years. Persons ≥ 60 years were less likely to have typical COVID-19 symptoms while more likely to have multiple comorbidities, multifocal pneumonia, and to be admitted to intensive care. The death rate was 27% among persons ≥60 years versus 4% in those <60 years (p<.01). Furthermore, most deaths (n=40, 75%) occurred among residents of long-term care facilities (LCFs). Conclusions: We describe early COVID-19 cases among predominantly Black and older patients from a single center safety net hospital. COVID-19 related mortality occurred predominantly among older patients from LCFs highlighting the need for improved preparedness and supporting prioritization of vaccination efforts in such settings.
Keywords	covid19
Language	English
Publishing date	2022-06-17
Publisher	Cold Spring Harbor Laboratory Press
Document type	Article ; Online
DOI	10.1101/2022.06.16.22276514
Database	COVID19

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