The Ecology of Antihypertensives in the United States, 1997-2017

AbstractBackgroundAntihypertensives are the most used medication type in the United States, yet there remains uncertainty about the use of different antihypertensives. We sought to characterize use of antihypertensives by and within medication class(es) between 1997-2017.MethodsA repeated cross-sectional study of 493,596 adult individuals using the 1997-2017 Medical Expenditure Panel Survey (MEPS). The Orange Book and published research were used for adjunctive information. The primary outcome was the estimated use by and within anti-hypertensive medication class(es).ResultsThe proportion of individuals taking any antihypertensive during a year increased from 1997 to the early 2010’s and then remained stable. The proportion of the population taking 2 or more medications declined from 2015-2017. The proportion of adults using angiotensin II receptor-blockers (ARBs) and dihydropyridine calcium channel-blockers (CCBs) increased during the study period, while angiotensin-converting enzyme inhibitors (ACE-Is) increased until 2010 after which rates remained stable. Beta-blocker use was similar to ACE-Is with an earlier decline starting in 2012. Thiazide diuretic use increased from 1997-2007, leveled off until 2014, and declined from 2015-2017. Non-dihydropyridine CCBs use declined throughout the study. ACE-Is, ARBs, CCBs, thiazide diuretics, and loop diuretics all had one dominant in-class medication. There was a clear increase in the use of losartan within ARBs, lisinopril within ACE-Is, and amlodipine within CCBs following generic conversion. Furosemide and hydrochlorothiazide started with and maintained a dominant position in their classes. Metoprolol use increased throughout the study and became the dominant beta-blocker, while atenolol peaked around 2005 and then declined thereafter.ConclusionsAntihypertensive classes appear to have a propensity to equilibrate to an individual medication, despite a lack of outcomes based research to compare medications within a class. Future research could focus on comparative effectiveness for within-class medications early in the life cycle of therapeutics that are probable to have wide spread use.

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Health Costs of Older Opioid Users with Pain and Comorbid Hypercholesterolemia or Hypertension in the United States

Diseases ◽

10.3390/diseases9020041 ◽

2021 ◽

Vol 9 (2) ◽

pp. 41

Author(s):

David R. Axon ◽

Srujitha Marupuru ◽

Shannon Vaffis

Keyword(s):

United States ◽

Healthcare Expenditure ◽

Medical Expenditure Panel Survey ◽

Prescription Medication ◽

The United States ◽

Medical Expenditure ◽

Future Research ◽

Linear Regression Models ◽

Healthcare Expenditures ◽

Opioid Users

This retrospective cross-sectional database study used 2018 Medical Expenditure Panel Survey data to quantify and assess differences in healthcare expenditures between opioid users and non-users among a non-institutionalized sample of older (≥50 years) United States adults with pain in the past four weeks and a diagnosis of comorbid hypercholesterolemia (pain–hypercholesterolemia group) or hypertension (pain–hypertension group). Hierarchical multivariable linear regression models were constructed by using logarithmically transformed positive cost data and adjusting for relevant factors to assess cost differences between groups. Percent difference between opioid users and non-users was calculated by using semi-logarithmic equations. Healthcare costs included inpatient, outpatient, office-based, emergency room, prescription medication, other, and total costs. In adjusted analyses, compared to non-users, opioid users in the pain–hypercholesterolemia and pain–hypertension groups respectively had 66% and 60% greater inpatient expenditure, 46% and 55% greater outpatient expenditure, 67% and 72% greater office-based expenditure, 50% and 60% greater prescription medication expenditure, 24% and 22% greater other healthcare expenditure, and 85% and 93% greater total healthcare expenditure. In conclusion, adjusted total healthcare expenditures were 85–93% greater among opioid users versus non-users in older United States adults with pain and comorbid hypercholesterolemia or hypertension. Future research is needed to identify opioid use predictors among these populations and reduce expenditures.

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The Effect of Massachusetts' Health Reform on Employer-Sponsored Insurance Premiums

Forum for Health Economics & Policy ◽

10.2202/1558-9544.1204 ◽

2010 ◽

Vol 13 (2) ◽

Cited By ~ 6

Author(s):

John F Cogan ◽

R. Glenn Hubbard ◽

Daniel Kessler

Keyword(s):

United States ◽

Health Reform ◽

Medical Expenditure Panel Survey ◽

Private Insurance ◽

The United States ◽

Medical Expenditure ◽

Insurance Premiums ◽

Reform Plan ◽

The Difference ◽

The Cost

In this paper, we use publicly available data from the Medical Expenditure Panel Survey - Insurance Component (MEPS-IC) to investigate the effect of Massachusetts' health reform plan on employer-sponsored insurance premiums. We tabulate premium growth for private-sector employers in Massachusetts and the United States as a whole for 2004 - 2008. We estimate the effect of the plan as the difference in premium growth between Massachusetts and the United States between 2006 and 2008that is, before versus after the planover and above the difference in premium growth for 2004 to 2006. We find that health reform in Massachusetts increased single-coverage employer-sponsored insurance premiums by about 6 percent, or $262. Although our research design has important limitations, it does suggest that policy makers should be concerned about the consequences of health reform for the cost of private insurance.

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Are There Racial Disparities in Psychotropic Drug Use and Expenditures in a Nationally Representative Sample of Men in the United States? Evidence From the Medical Expenditure Panel Survey

American Journal of Men s Health ◽

10.1177/1557988313496564 ◽

2013 ◽

Vol 8 (1) ◽

pp. 82-90 ◽

Cited By ~ 6

Author(s):

Geraldine Pierre ◽

Roland J. Thorpe ◽

Gniesha Y. Dinwiddie ◽

Darrell J. Gaskin

Keyword(s):

United States ◽

Drug Use ◽

Racial Disparities ◽

Psychotropic Drug ◽

Medical Expenditure Panel Survey ◽

The United States ◽

Medical Expenditure ◽

Panel Survey ◽

Psychotropic Drug Use ◽

Nationally Representative

This article sought to determine whether racial disparities exist in psychotropic drug use and expenditures in a nationally representative sample of men in the United States. Data were extracted from the 2000-2009 Medical Expenditure Panel Survey, a longitudinal survey that covers the U.S. civilian noninstitutionalized population. Full-Year Consolidated, Medical Conditions, and Prescribed Medicines data files were merged across 10 years of data. The sample of interest was limited to adult males aged 18 to 64 years, who reported their race as White, Black, Hispanic, or Asian. This study employed a pooled cross-sectional design and a two-part probit generalized linear model for analyses. Minority men reported a lower probability of psychotropic drug use (Black = −4.3%, 95% confidence interval [CI] = [−5.5, −3.0]; Hispanic = −3.8%, 95% CI = [−5.1, −2.6]; Asian = −4.5%, 95% CI = [−6.2, −2.7]) compared with White men. After controlling for demographic, socioeconomic, and health status variables, there were no statistically significant race differences in drug expenditures. Consistent with previous literature, racial and ethnic disparities in the use of psychotropic drugs present problems of access to mental health care and services.

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Prevalence of and Sociodemographic Disparities in Influenza Vaccination Among Adults With Diabetes in the United States

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa139 ◽

2020 ◽

Vol 4 (11) ◽

Cited By ~ 1

Author(s):

Priyanka Bhugra ◽

Reed Mszar ◽

Javier Valero-Elizondo ◽

Gowtham R Grandhi ◽

Salim S Virani ◽

...

Keyword(s):

United States ◽

Influenza Vaccination ◽

Medical Expenditure Panel Survey ◽

Vaccine Coverage ◽

The United States ◽

Sociodemographic Factors ◽

Medical Expenditure ◽

Sociodemographic Characteristics ◽

Black Race ◽

Patients With Diabetes

Abstract National estimates describing the overall prevalence of and disparities in influenza vaccination among patients with diabetes mellitus (DM) in United States are not well described. Therefore, we analyzed the prevalence of influenza vaccination among adults with DM, overall and by sociodemographic characteristics, using the Medical Expenditure Panel Survey database from 2008 to 2016. Associations between sociodemographic factors and lack of vaccination were examined using adjusted logistic regression. Among adults with DM, 36% lacked influenza vaccination. Independent predictors of lacking influenza vaccination included age 18 to 39 years (odds ratio [OR] 2.54; 95% confidence interval [CI], 2.14-3.00), Black race/ethnicity (OR 1.29; 95% CI, 1.14-1.46), uninsured status (OR 1.88; 95% CI, 1.59-2.21), and no usual source of care (OR 1.61; 95% CI, 1.39-1.85). Nearly 64% individuals with ≥ 4 higher-risk sociodemographic characteristics lacked influenza vaccination (OR 3.50; 95% CI 2.79-4.39). One-third of adults with DM in the United States lack influenza vaccination, with younger age, Black race, and lower socioeconomic status serving as strong predictors. These findings highlight the continued need for focused public health interventions to increase vaccine coverage and utilization among disadvantaged communities.

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Another Paradox? The Life Satisfaction of Older Hispanic Immigrants in the United States

Journal of Aging and Health ◽

10.1177/0898264315624901 ◽

2016 ◽

Vol 29 (1) ◽

pp. 3-24 ◽

Cited By ~ 16

Author(s):

Rocío Calvo ◽

Dawn C. Carr ◽

Christina Matz-Costa

Keyword(s):

United States ◽

Life Satisfaction ◽

Functional Limitations ◽

The United States ◽

Ordinary Least Squares ◽

Future Research ◽

Hispanic Immigrants ◽

Cross Sectional ◽

Socioeconomic Resources ◽

Hispanic White

Objective: To investigate disparities in life satisfaction among older Hispanic immigrants in the United States relative to their native-born Hispanic and non-Hispanic White counterparts, and to identify factors associated with such disparities. Method: Cross-sectional data from 9,798 individuals age 60 and above from the Health and Retirement Study (HRS) were used to estimate ordinary least squares (OLS) regression models. Results: Hispanic immigrants reported the highest levels of life satisfaction of all groups. Wealthier older adults, who were socially engaged, had social support, and experienced fewer functional limitations and lower exposure to discrimination, were more satisfied with their lives in the overall sample. Interaction effects revealed that although education was associated with greater life satisfaction only among non-Hispanic Whites, co-residing with children was associated with greater life satisfaction only among Hispanics. Discussion: Although older Hispanic immigrants had the least amount of socioeconomic resources of all groups in our study, they were the most satisfied with their lives. Possible explanations and directions for future research are discussed.

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