Introduction
Smoking is the leading cause of preventable disease and death. However, effective
medicines, including prescription medications often covered by health insurance, are
available to aid cessation.
Methods
Trends of 7 U.S. Food and Drug Administration–approved prescription medications for
smoking cessation during 2009–2019 (before and during Affordable Care Act implementation),
including fill counts and spending (total and patient, adjusted to 2019 U.S. dollars),
were assessed among U.S. adults aged ≥18 years. Symphony Health's Integrated Dataverse
combines data on >90% of outpatient prescription fills with market purchasing data
to create national estimates. Analyses were conducted in 2021.
Results
Annually, total fills (spending) decreased from 3.7 million ($577 million) in 2009
to 2.5 million ($465 million) in 2013 and increased to 4.5 million ($1.279 billion)
in 2019; patient spending decreased from $174 million (30% of total annual spending)
in 2009 to $54 million (4%) in 2019. Comparing 2009 with 2019, the total spending
per fill increased by 80% (from $157 to $282), whereas patient spending per fill decreased
by 75% (from $47 to $12). The total spending per fill for branded products increased
by 175% (from $166 to $459) and decreased by 41% (from $75 to $44) for generic products.
Branded product percentage decreased from 89% to 57%.
Conclusions
Total fills and spending decreased from 2009 to 2013 and then increased through 2019,
whereas patient spending decreased. Earlier studies suggest possible reasons for these
trends, such as gradual implementation of federal requirements for insurance coverage
of cessation medications and reduced cost sharing and financial barriers.
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Article Info
Publication History
Published online: March 28, 2022
Identification
Copyright
Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine.
