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The issues to patients are particularly relevant in recent years, with a growing trend of shifting costs of treatment expenses to patients in various forms, such as high deductibles, copays, and\u00a0coinsurance. Therefore, the issue of\n            <jats:italic>\u201c<\/jats:italic>\n            financial toxicity\u201d of health care is gaining significant attention. The term encapsulates the deleterious impact of healthcare expenditures for patients. This includes the economic burden posed by healthcare costs, but also the unintended consequences it creates in form of barriers to necessary medical care, quality of life as well tradeoffs related to non\u2010health\u2013related necessities. While the societal impact of rising costs related to ASCVD management have been actively studied and debated in policy circles, there is lack of a comprehensive assessment of the current literature on the financial impact of cost sharing for ASCVD patients and their families. In this review we systematically describe the scope and domains of financial toxicity, the instruments that measure various facets of healthcare\u2010related financial toxicity, and accentuating factors and consequences on patient health and well\u2010being. We further identify avenues and potential solutions for clinicians to apply in medical practice to mitigate the burden and consequences of out\u2010of\u2010pocket costs for ASCVD patients and their families.\n          <\/jats:p>","DOI":"10.1161\/jaha.120.017793","type":"journal-article","created":{"date-parts":[[2020,9,13]],"date-time":"2020-09-13T09:07:52Z","timestamp":1599988072000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":136,"title":["Financial Toxicity in Atherosclerotic Cardiovascular Disease in the United States: Current State and Future Directions"],"prefix":"10.1161","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9467-6199","authenticated-orcid":false,"given":"Rohan","family":"Khera","sequence":"first","affiliation":[{"name":"Section of Cardiovascular Medicine, Department of Internal Medicine Yale School of Medicine New Haven CT"},{"name":"Center for Outcomes Research and Evaluation Yale\u2010New Haven Hospital New Haven CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Valero-Elizondo","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Prevention and Wellness Houston Methodist DeBakey Heart and Vascular Center Houston TX"},{"name":"Center for Outcomes Research Houston Methodist Houston TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5376-2269","authenticated-orcid":false,"given":"Khurram","family":"Nasir","sequence":"additional","affiliation":[{"name":"Section of Cardiovascular Medicine, Department of Internal Medicine Yale School of Medicine New Haven CT"},{"name":"Division of Cardiovascular Prevention and Wellness Houston Methodist DeBakey Heart and Vascular Center Houston TX"},{"name":"Center for Outcomes Research Houston Methodist Houston TX"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","unstructured":"Khavjou OA Phelps D Leib A. 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