{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T02:03:56Z","timestamp":1768442636645,"version":"3.49.0"},"reference-count":9,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>FDA approved an exhalation delivery system with fluticasone (EDS\u2010FLU) for treatment of chronic rhinosinusitis with (2017) and without (2024) nasal polyposis. Concerns have emerged that high prices may limit access, but little is known about the extent of adoption. We analyzed publicly available Securities and Exchange Commission filings and Medicare Part D spending data to characterize EDS\u2010FLU utilization, spending, and prices between 2018 and 2023. During this period, annual EDS\u2010FLU utilization and spending increased 10.3\u2010fold (32,869 to 339,400 prescriptions) and 12\u2010fold ($21.1 million to $252.9 million), respectively. Despite reductions in the manufacturer net price ($272.98 to $228.34 per prescription after rebates\/discounts; relative difference \u221216.4%), the Medicare Part D point\u2010of\u2010sale price increased ($642.72 to $745.11; relative difference 15.9%). In 2023, pharmacy markup ($516.77) over acquisition costs accounted for 69.4% of the point\u2010of\u2010sale net price. Policy reforms limiting price inflation by pharmaceutical supply chain intermediaries are necessary to promote access and lower drug spending.<\/jats:p>","DOI":"10.1002\/ohn.70058","type":"journal-article","created":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T07:27:59Z","timestamp":1761204479000},"page":"280-284","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Price and Adoption of Exhalation Delivery System With Fluticasone, 2018\u20102023"],"prefix":"10.1002","volume":"174","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 &amp; Neck Surgery University of California San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katie M.","family":"Phillips","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery University of Cincinnati College of Medicine Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akash M.","family":"Bhat","sequence":"additional","affiliation":[{"name":"Drexel University College of Medicine Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George A.","family":"Scangas","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Division of Rhinology, Massachusetts Eye and Ear Boston Massachusetts 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 Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vinay K.","family":"Rathi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery The Ohio State University Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,23]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/1945892418810281"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22693"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22851"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.23362"},{"key":"e_1_2_8_6_1","unstructured":"Optinose Optinose 10K SEC Filings.https:\/\/ir.optinose.com\/sec-filings. 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