Evidence map›Paper›PMID 39196717›Full record

ArticleUrology practice2024

The 340B Program and High-Risk Prescribing of Oral Targeted Therapies for Advanced Prostate Cancer.

Kassem S Faraj, Mary Oerline, Samuel R Kaufman, Christopher Dall, Arnav Srivastava, Megan E V Caram, Vahakn B Shahinian, Brent K Hollenbeck

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Urology practice, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Kassem S FarajDow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, Michigan.
Mary OerlineDow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, Michigan.
Samuel R KaufmanDow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, Michigan.
Christopher DallDepartment of Urology, Massachusetts General Hospital, Boston, Massachusetts.
Arnav SrivastavaDow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, Michigan.
Megan E V CaramVA Health Services Research & Development, Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan.
Vahakn B ShahinianDivision of Nephrology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan.
Brent K HollenbeckDepartment of Urology, Massachusetts General Hospital, Boston, Massachusetts.

Funding

Advanced Training in Urologic OncologyT32CA180984 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Ganesh S Palapattu, VAHAKN B SHAHINIAN · 2014 to 2026
$3.4M
Aligning financial incentives to promote rational use of active surveillance for prostate cancerR01CA269367 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI BRENT K. HOLLENBECK, VAHAKN B SHAHINIAN · 2022 to 2026
$2.8M
Physician dispensing of oral specialty drugs for advanced prostate cancer and its implications for patientsR01CA275993 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI HOLLENBECK, BRENT K., SHAHINIAN, VAHAKN B · 2023 to 2025
$2.5M
NCI NIH HHS R01 CA269367NCI NIH HHS R01 CA275993NCI NIH HHS T32 CA180984
6 · The paper itself

Abstract

introductionThe use of expensive oral targeted agents for advanced prostate cancer can be influenced by those who stand to gain from their use. The 340B drug pricing program allows eligible hospitals to purchase medications at steep discounts, generating millions of dollars in savings. The extent to which hospitals engage in higher-risk prescribing due to program incentives is unclear.

methodsMedicare claims were used to perform a retrospective study of men with advanced prostate cancer. The primary outcome was targeted therapy use in men with high noncancer mortality risk. Secondary outcomes included androgen biosynthesis inhibitor use in men with cardiovascular history, androgen receptor inhibitor use in men with neurocognitive history, and therapy within 14 days of death. Proportional hazards models were used to assess time-to-event outcomes, while logistic regression was used for binary outcomes.

resultsIn men with high noncancer mortality risk, targeted therapy use did not differ at 340B participating compared to nonparticipating hospitals (hazard ratio [HR] 1.1, 95% CI 0.67-1.5). There was no difference in androgen biosynthesis inhibitor use in men with a prior cardiac event (HR 0.96, 95% CI 0.70-1.3) or androgen receptor inhibitor use in men with a prior neurocognitive event (HR 1.5, 95% CI 0.65-3.4) in those treated at 340B participating compared to nonparticipating hospitals. Therapy use in the last 14 days of life did not vary by 340B participation (odds ratio 1.3, 95% CI 0.86-1.9).

conclusionsIn men with advanced prostate cancer, high-risk prescribing and futility measures did not vary by participation in the 340B drug pricing program.

Indexed as

Prostatic NeoplasmsAdministration, OralAgedAged, 80 and overAndrogen AntagonistsAndrogen Receptor AntagonistsAntineoplastic AgentsHumansMaleMedicareMolecular Targeted TherapyPractice Patterns, Physicians'Retrospective StudiesUnited StatesAndrogen AntagonistsAndrogen Receptor AntagonistsAntineoplastic Agents340B drug pricing programfinancial incentivesovertreatmentprostate cancerquality

Identifiers

PMID39196717
PMCPMC11489025

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.