Graham Smith|Supriya Shore|Larry A. Allen|David W. Markham|Amy L. Mitchell|Miranda Moore|Alanna A. Morris|Candace Speight|Neal W. Dickert
Discussing Out?of?Pocket Costs With Patients: Shared Decision Making for Sacubitril?Valsartan in Heart Failure
Emory University|University of Michigan–Ann Arbor|University of Colorado Denver|Emory University|Emory University|Emory University|Emory University|Emory University|Emory University
background financial toxicity concern patients little known patients consider outofpocket cost decisions sacubitrilvalsartan provides contemporary scenario understand financial toxicity guideline recommended heart failure reduced ejection fraction yet outofpocket costs considerable methods results structured interviews conducted 49 patients heart failure reduced ejection fraction heart failure clinics inpatient services patient opinions drug value solicited description benefits using graphical displays descriptive quantitative analysis closedended responses conducted qualitative descriptive analysis text data performed participants 92 4549 said would definitely probably switch sacubitrilvalsartan physician recommended outofpocket cost 5 per month current medication 43 2149 would outofpocket cost 100 per month p lt0001 least 40 across income categories would unlikely take sacubitrilvalsartan 100 per month participants exhibited heterogeneous approaches cost decision making varied use interpretation probabilistic information 20 participants stated physicians initiated conversation cost past year conclusions outofpocket cost variation reflective contemporary cost sharing substantially influenced stated willingness take sacubitrilvalsartan guidelinerecommended therapy mortality benefit findings suggest need cost transparency promote shared decision making also demonstrate complexity cost discussion need study incorporate outofpocket cost clinical decisions