{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:44:21Z","timestamp":1761007461399,"version":"build-2065373602"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,10,16]],"date-time":"2024-10-16T00:00:00Z","timestamp":1729036800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>High prescription drug prices can financially strain patients and insurers, with substantial clinical repercussions. In recent years, direct\u2010to\u2010consumer (DTC) pharmacies have emerged as potentially lower\u2010cost alternatives for patients to fill prescriptions. We evaluated whether drugs commonly prescribed by otolaryngologists were available at a national DTC pharmacy (Mark Cuban Cost Plus Drug Company [MCCPDC]) and estimated potential Medicare savings from DTC pricing. We identified drugs and prices paid by Medicare Part D plans using the 2021 Drug Spending Dashboard. Our analysis included 16 generic drugs within the MCCPDC formulary, which offered lower prices for 14 (87.5%) drugs. If plans had secured MCCPDC pricing for all 16 drugs, Medicare patients and plans would have saved $2.9 billion (relative reduction: 62.3%) in 2021. Estimated total savings were greatest for budesonide\u2010formoterol ($1.9 billion), dexlansoprazole ($464.6 million), and levothyroxine ($327.4 million). Otolaryngologists and insurers may consider utilizing DTC pharmacies with lower drug prices, though patients may face challenges projecting out\u2010of\u2010pocket costs across pharmacies, medications, benefit phases, and formulary tiers.<\/jats:p>","DOI":"10.1002\/ohn.1023","type":"journal-article","created":{"date-parts":[[2024,10,16]],"date-time":"2024-10-16T15:48:41Z","timestamp":1729093721000},"page":"360-365","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Availability and Pricing of Drugs Prescribed by Otolaryngologists Through a Direct\u2010to\u2010Consumer Pharmacy: Medicare Savings Implications"],"prefix":"10.1002","volume":"172","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5289-4251","authenticated-orcid":false,"given":"Taylor S.","family":"Erickson","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven D.","family":"Pletcher","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zachary M.","family":"Soler","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Division of Rhinology and Sinus Surgery Medical University of South Carolina Charleston South Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodney J.","family":"Schlosser","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Division of Rhinology and Sinus Surgery Medical University of South Carolina Charleston South Carolina USA"},{"name":"Department of Surgery Ralph H. Johnson VA Medical Center Charleston South Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan D.","family":"Workman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Division of Rhinology Massachusetts Eye and Ear Infirmary Boston, MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vinay K.","family":"Rathi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Division of Rhinology and Sinus Surgery Medical University of South Carolina Charleston South Carolina USA"},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery The Ohio State University Wexner Medical Center Columbus USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,10,16]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.3.332"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.11237"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaophthalmol.2024.1717"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/oncolo\/oyae083"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/OP.2023.19.11_suppl.18"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.23.00079"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000003083"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/UPJ.0000000000000510"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2023.1179253"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.7326\/M22-0756"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.120.007449"},{"key":"e_1_2_8_13_1","unstructured":"National Cancer Institute. Financial Toxicity (Financial Distress) and Cancer Treatment (PDQ\u00ae)\u2013Patient Version; 2024. Accessed May 31 2024.https:\/\/www.cancer.gov\/about-cancer\/managing-care\/track-care-costs\/financial-toxicity-pdq#:~:text=One%20study%20found%20that%20patients risk%20factor%20for%20financial%20toxicity"},{"key":"e_1_2_8_14_1","unstructured":"Centers for Medicare & Medicaid Services Data. Medicare Part D Spending by Drug; 2024. Accessed April 27 2024.https:\/\/data.cms.gov\/summary-statistics-on-use-and-payments\/medicare-medicaid-spending-by-drug\/medicare-part-d-spending-by-drug"},{"key":"e_1_2_8_15_1","unstructured":"Centers for Medicare & Medicaid Services Data. Medicare Part D Spending by Drug Methodology. Accessed April 27 2024.https:\/\/data.cms.gov\/sites\/default\/files\/2024-03\/DSD_PTD_RY24_20240212_Methodology_WDDSE_508.pdf"},{"key":"e_1_2_8_16_1","unstructured":"Bureau of Labor Statistics US Department of Labor. Consumer Price Index\u2010December 2023; 2023. 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