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CF, GD, and CP are employees of Milliman, Inc., who received consulting fees from Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA. KEK participated in United Therapeutics speaker\u2019s bureau 2018\u20132021 and served on advisory boards and as a consultant for United Therapeutics, J&J Actelion, Acceleron, and Merck & Co., Inc., Rahway, NJ, USA.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Ethics approval is not required as this project does not include any interaction with human subjects and only uses publicly available de-identified claims data.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Not applicable.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"The data that support the findings of this study are available from the authors but restrictions apply to the availability of these data, which were obtained under license from the Centers for Medicare & Medicaid Services (CMS), Merative L.P., and Milliman, Inc.. As such, data used for this study are not publicly available.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Availability of data and materials"}},{"value":"Substantial contributions to the conception or design of the work: all authors. Data analysis: CF, CP. Interpretation of data for the work: all authors. Drafting the work or reviewing it critically for important intellectual content: all authors. Final approval of the version to be published: all authors. The authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Author contributions"}}]}}