{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T22:04:45Z","timestamp":1791669885709,"version":"4.3.4"},"reference-count":30,"publisher":"Elsevier BV","issue":"2","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T00:00:00Z","timestamp":1766966400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000897","name":"Cystic Fibrosis Foundation","doi-asserted-by":"publisher","award":["REN20Q10"],"award-info":[{"award-number":["REN20Q10"]}],"id":[{"id":"10.13039\/100000897","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000897","name":"Cystic Fibrosis Foundation","doi-asserted-by":"publisher","award":["VANCIT23A0 -LAD"],"award-info":[{"award-number":["VANCIT23A0 -LAD"]}],"id":[{"id":"10.13039\/100000897","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","cysticfibrosisjournal.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Cystic Fibrosis"],"published-print":{"date-parts":[[2026,3]]},"DOI":"10.1016\/j.jcf.2025.12.021","type":"journal-article","created":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T20:26:02Z","timestamp":1767039962000},"page":"296-304","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":3,"title":["Financial and healthcare tradeoffs associated with cystic fibrosis care in the United States: A cross-sectional study"],"prefix":"10.1016","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2961-5661","authenticated-orcid":false,"given":"Aricca D.","family":"Van Citters","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2090-1550","authenticated-orcid":false,"given":"Karen","family":"Carey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clement L.","family":"Ren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna","family":"Phan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2583-440X","authenticated-orcid":false,"given":"Laura","family":"Beidler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel R.","family":"King","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4142-9449","authenticated-orcid":false,"given":"Enid","family":"Aliaj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debbie","family":"Benitez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katelyn","family":"Broekema","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4332-4112","authenticated-orcid":false,"given":"A. Whitney","family":"Brown","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristen","family":"Clemm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5460-7981","authenticated-orcid":false,"given":"Christina L.","family":"Duncan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac","family":"Groenendyk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deirdre","family":"Jennings","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghan E.","family":"McGarry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2470-9079","authenticated-orcid":false,"given":"Ryan C.","family":"Perkins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory S.","family":"Sawicki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheila","family":"Rossi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Shaver","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0829-0474","authenticated-orcid":false,"given":"Anne","family":"Willis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8218-1372","authenticated-orcid":false,"given":"Olivia","family":"Dieni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jcf.2025.12.021_bib0001","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1016\/j.jcf.2023.02.009","article-title":"Cystic fibrosis prevalence in the United States and participation in the Cystic Fibrosis Foundation Patient Registry in 2020","volume":"22","author":"Cromwell","year":"2023","journal-title":"J Cyst Fibros"},{"key":"10.1016\/j.jcf.2025.12.021_bib0002","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1016\/j.jcf.2022.01.009","article-title":"Worldwide rates of diagnosis and effective treatment for cystic fibrosis","volume":"21","author":"Guo","year":"2022","journal-title":"J Cyst Fibros"},{"key":"10.1016\/j.jcf.2025.12.021_bib0003","series-title":"2024 Cystic fibrosis foundation patient registry highlights","year":"2025"},{"key":"10.1016\/j.jcf.2025.12.021_bib0004","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.1016\/j.jcf.2024.09.002","article-title":"Adapting the cystic fibrosis care model: perspectives from people with CF, caregivers, and members of CF care teams","volume":"23","author":"Tran","year":"2024","journal-title":"J Cyst Fibros"},{"key":"10.1016\/j.jcf.2025.12.021_bib0005","first-page":"599","article-title":"Gleason PP. Real-world outcomes and direct care cost before and after elexacaftor\/tezacaftor\/ivacaftor initiation in commercially insured members with cystic fibrosis","volume":"29","author":"Marshall","year":"2023","journal-title":"J Manag Care Spec Pharm"},{"key":"10.1016\/j.jcf.2025.12.021_bib0006","first-page":"57","article-title":"Cost, coverage, and the underuse of medications among people with CF","author":"Seyoum","year":"2020","journal-title":"Health Policy Manag Issue Br"},{"key":"10.1016\/j.jcf.2025.12.021_bib0007","series-title":"Health policy and management issue briefs: Paper 59","article-title":"Risk indicators of food insecurity in the CF population","author":"Seyoum","year":"2021"},{"key":"10.1016\/j.jcf.2025.12.021_bib0008","unstructured":"Nolan L., Seyoum S., Wilson J., Regenstein M. Non-elderly adults on disability in the CF population. Health policy and management issue briefs: Paper 62; 2021. https:\/\/hsrc.himmelfarb.gwu.edu\/sphhs_policy_briefs\/."},{"key":"10.1016\/j.jcf.2025.12.021_bib0009","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1016\/j.jcf.2023.01.002","article-title":"Cost burden among the CF population in the United States: a focus on debt, food insecurity, housing and health services","volume":"22","author":"Seyoum","year":"2023","journal-title":"J Cyst Fibros"},{"key":"10.1016\/j.jcf.2025.12.021_bib0010","article-title":"Socioeconomic burden of cystic fibrosis in Canada","volume":"11","author":"Laflamme","year":"2024","journal-title":"BMJ Open Respir Res"},{"key":"10.1016\/j.jcf.2025.12.021_bib0011","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1016\/j.jcf.2024.06.010","article-title":"Wellness in the modulator era: an observational study of the impact of CFTR modulator therapy on the well-being of people with cystic fibrosis","volume":"24","author":"Van Citters","year":"2025","journal-title":"J Cyst Fibros"},{"key":"10.1016\/j.jcf.2025.12.021_bib0012","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1016\/j.jcf.2025.01.001","article-title":"Impact of CFTR modulator therapy on basic life needs and financial concerns in people with cystic fibrosis: data from the Well-ME survey","volume":"24","author":"Boas","year":"2025","journal-title":"J Cyst Fibros"},{"key":"10.1016\/j.jcf.2025.12.021_bib0013","doi-asserted-by":"crossref","first-page":"2841","DOI":"10.1007\/s11135-021-01252-1","article-title":"Ensuring survey research data integrity in the era of internet bots","volume":"56","author":"Griffin","year":"2022","journal-title":"Qual Quant"},{"key":"10.1016\/j.jcf.2025.12.021_bib0014","article-title":"Annual update of the HHS Poverty Guidelines","volume":"89","year":"2024","journal-title":"Fed Regist"},{"key":"10.1016\/j.jcf.2025.12.021_bib0015","series-title":"Geographic division or region","article-title":"National Center for Health Statistics","year":"2025"},{"key":"10.1016\/j.jcf.2025.12.021_bib0016","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1007\/s11136-009-9496-9","article-title":"Development of physical and mental health summary scores from the patient-reported outcomes measurement information system (PROMIS) global items","volume":"18","author":"Hays","year":"2009","journal-title":"Qual Life Res"},{"key":"10.1016\/j.jcf.2025.12.021_bib0017","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1007\/s11136-013-0581-8","article-title":"Development of the PROMIS (R) pediatric global health (PGH-7) measure","volume":"23","author":"Forrest","year":"2014","journal-title":"Qual Life Res"},{"key":"10.1016\/j.jcf.2025.12.021_bib0018","unstructured":"Centers for Medicare & Medicaid Services. A guide to using the Accountable Health Communities health-related social needs screening tool: promising practices and key insights. 2023."},{"key":"10.1016\/j.jcf.2025.12.021_bib0019","article-title":"IBM SPSS statistics for Mac","year":"2021","journal-title":"Armonk"},{"key":"10.1016\/j.jcf.2025.12.021_bib0020","unstructured":"ATLAS.ti Scientific Software Development GmbH. ATLASti Mac Version 23.3. 2024."},{"key":"10.1016\/j.jcf.2025.12.021_bib0021","article-title":"The cost of cystic fibrosis 2022","author":"Earlam","year":"2022","journal-title":"Cyst Fibros Trust"},{"key":"10.1016\/j.jcf.2025.12.021_bib0022","doi-asserted-by":"crossref","DOI":"10.1016\/j.jcf.2025.03.1286","article-title":"P402 Cost burden and cystic fibrosis: a comparison between the United States and the United Kingdom","volume":"24","author":"Dieni","year":"2025","journal-title":"J Cyst Fibros"},{"key":"10.1016\/j.jcf.2025.12.021_bib0023","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.jcf.2024.10.010","article-title":"Associations between income level and health outcomes in people with cystic fibrosis in Turkey","volume":"24","author":"Metin Cakar","year":"2025","journal-title":"J Cyst Fibros"},{"key":"10.1016\/j.jcf.2025.12.021_bib0024","doi-asserted-by":"crossref","first-page":"S222","DOI":"10.1016\/S1569-1993(24)01259-1","article-title":"(419) Clinician perspectives and practices related to cost of care discussions among people with cystic fibrosis","volume":"23","author":"Perkins","year":"2024","journal-title":"J Cyst Fibros"},{"key":"10.1016\/j.jcf.2025.12.021_bib0025","first-page":"1","article-title":"Multimorbidity in the modulator era: challenges of managing an ageing cystic fibrosis population","author":"Chan","year":"2025","journal-title":"Expert Rev Respir Med"},{"key":"10.1016\/j.jcf.2025.12.021_bib0026","unstructured":"Cystic Fibrosis Foundation. Get help with CF Foundation Compass, 2025. Accessed July 21. https:\/\/www.cff.org\/support\/get-help-cf-foundation-compass."},{"key":"10.1016\/j.jcf.2025.12.021_bib0027","article-title":"When the debt collector calls: the financial burden of people with CF","author":"Seyoum","year":"2020","journal-title":"N Am Cyst Fibros Conf Virtual conference"},{"key":"10.1016\/j.jcf.2025.12.021_bib0028","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1037\/hea0000242","article-title":"Understanding associations among race, socioeconomic status, and health: patterns and prospects","volume":"35","author":"Williams","year":"2016","journal-title":"Health Psychol"},{"key":"10.1016\/j.jcf.2025.12.021_bib0029","first-page":"35","article-title":"Left behind: the potential impact of CFTR modulators on racial and ethnic disparities in cystic fibrosis","volume":"42","author":"McGarry","year":"2022","journal-title":"Paediatr Respir Rev"},{"key":"10.1016\/j.jcf.2025.12.021_bib0030","doi-asserted-by":"crossref","first-page":"S74","DOI":"10.1002\/ppul.24434","article-title":"The demographics of adverse outcomes in cystic fibrosis","volume":"54","author":"McGarry","year":"2019","journal-title":"Pediatr Pulmonol"}],"container-title":["Journal of Cystic Fibrosis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1569199325025524?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1569199325025524?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T11:36:04Z","timestamp":1781782564000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1569199325025524"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":30,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["S1569199325025524"],"URL":"https:\/\/doi.org\/10.1016\/j.jcf.2025.12.021","relation":{},"ISSN":["1569-1993"],"issn-type":[{"value":"1569-1993","type":"print"}],"subject":[],"published":{"date-parts":[[2026,3]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Financial and healthcare tradeoffs associated with cystic fibrosis care in the United States: A cross-sectional study","name":"articletitle","label":"Article Title"},{"value":"Journal of Cystic Fibrosis","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jcf.2025.12.021","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 The Authors. Published by Elsevier B.V. on behalf of European Cystic Fibrosis Society.","name":"copyright","label":"Copyright"}]}}