{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T22:43:36Z","timestamp":1790981016809,"version":"4.1.0"},"reference-count":26,"publisher":"American Medical Association (AMA)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Intern Med"],"published-print":{"date-parts":[[2023,7,1]]},"abstract":"<jats:sec id=\"ab-ioi230023-4\"><jats:title>Importance<\/jats:title><jats:p>Prescription drug prices are a leading concern among patients and policy makers. There have been large and sharp price increases for some drugs, but the long-term implications of large drug price increases remain poorly understood.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi230023-5\"><jats:title>Objective<\/jats:title><jats:p>To examine the association of the large 2010 price increase in colchicine, a common treatment for gout, with long-term changes in colchicine use, substitution with other drugs, and health care use.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi230023-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This retrospective cohort study examined MarketScan data from a longitudinal cohort of patients with gout with employer-sponsored insurance from 2007 through 2019.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi230023-7\"><jats:title>Exposures<\/jats:title><jats:p>The US Food and Drug Administration\u2019s discontinuation of lower-priced versions of colchicine from the market in 2010.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi230023-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>Mean price of colchicine; use of colchicine, allopurinol, and oral corticosteroids; and emergency department (ED) and rheumatology visits for gout in year 1 and over the first decade of the policy (through 2019) were calculated. Data were analyzed between November 16, 2021, and January 17, 2023.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi230023-9\"><jats:title>Results<\/jats:title><jats:p>A total of 2\u202f723\u202f327 patient-year observations were examined from 2007 through 2019 (mean [SD] age of patients, 57.0 [13.8] years; 20.9% documented as female; 79.1% documented as male). The mean price per prescription of colchicine increased sharply from $11.25 (95% CI, $11.23-$11.28) in 2009 to $190.49 (95% CI, $190.07-$190.91) in 2011, a 15.9-fold increase, with the mean out-of-pocket price increasing 4.4-fold from $7.37 (95% CI, $7.37-$7.38) to $39.49 (95% CI, $39.42-$39.56). At the same time, colchicine use declined from 35.0 (95% CI, 34.6-35.5) to 27.3 (95% CI, 26.9-27.6) pills per patient in year 1 and to 22.6 (95% CI, 22.2-23.0) pills per patient in 2019. Adjusted analyses showed a 16.7% reduction in year 1 and a 27.0% reduction over the decade (<jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001). Meanwhile, adjusted allopurinol use rose by 7.8 (95% CI, 6.9-8.7) pills per patient in year 1, a 7.6% increase from baseline, and by 33.1 (95% CI, 32.6-33.7) pills per patient through 2019, a 32.0% increase from baseline over the decade (<jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001). Moreover, adjusted oral corticosteroid use exhibited no significant change in the first year, then increased by 1.5 (95% CI, 1.3-1.7) pills per patient through 2019, an 8.3% increase from baseline over the decade. Adjusted ED visits for gout rose by 0.02 (95% CI, 0.02-0.03) per patient in year 1, a 21.5% increase, and by 0.05 (95% CI, 0.04-0.05) per patient through 2019, a 39.8% increase over the decade (<jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001). Adjusted rheumatology visits for gout increased by 0.02 (95% CI, 0.02-0.03) per patient through 2019, a 10.5% increase over the decade (<jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001).<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi230023-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>In this cohort study among individuals with gout, the large increase in colchicine prices in 2010 was associated with an immediate decrease in colchicine use that persisted over approximately a decade. Substitution with allopurinol and oral corticosteroids was also evident. Increased ED and rheumatology visits for gout over the same period suggest poorer disease control.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamainternmed.2023.0898","type":"journal-article","created":{"date-parts":[[2023,5,8]],"date-time":"2023-05-08T16:36:12Z","timestamp":1683563772000},"page":"670","source":"Crossref","is-referenced-by-count":7,"title":["Changes in Prescription Drug and Health Care Use Over 9 Years After the Large Drug Price Increase for Colchicine"],"prefix":"10.1001","volume":"183","author":[{"given":"Dan P.","family":"Ly","sequence":"first","affiliation":[{"name":"Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles"},{"name":"VA Greater Los Angeles Healthcare System, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mia A.","family":"Giuriato","sequence":"additional","affiliation":[{"name":"Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zirui","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts"},{"name":"Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts"},{"name":"Center for Primary Care, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"9","key":"ioi230023r1","doi-asserted-by":"publisher","first-page":"826","DOI":"10.1001\/jama.2020.0359","article-title":"Relentless prescription drug price increases.","volume":"323","author":"Deb","year":"2020","journal-title":"JAMA"},{"issue":"22","key":"ioi230023r2","doi-asserted-by":"publisher","first-page":"2017","DOI":"10.1056\/NEJMp2113679","article-title":"Why is aducanumab priced at $56,000 per patient? 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