{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T02:38:06Z","timestamp":1771900686238,"version":"3.50.1"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,6,21]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Sacubitril\/valsartan improves health outcomes for heart failure with reduced ejection fraction relative to angiotensin\u2010converting enzyme inhibitors or angiotensin receptor blockers, but it carries higher out\u2010of\u2010pocket costs. Neither the impact of cost nor how to integrate cost into medical decisions is well studied.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              To evaluate the impact of out\u2010of\u2010pocket costs and a novel cost\u2010priming intervention on willingness to take sacubitril\/valsartan for heart failure with reduced ejection fraction, participants with self\u2010reported heart disease were surveyed using the online Ipsos Knowledge Panel. Participants were presented with a modified decision aid for sacubitril\/valsartan and then, in a 3\u00d72 factorial design, randomly assigned to 1 of 3 cost conditions ($10, $50, or $100\/month) and to a control group or cost\u2010priming intervention, defined by being asked questions about their financial situation before learning about the benefits of sacubitril\/valsartan. Of the 1013 participants included in the analysis, 85% of respondents were willing to take sacubitril\/valsartan at $10, 62% at $50, and 33% at $100 (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001). In a multivariable logistic regression model, participants were more likely to take sacubitril\/valsartan at $10 versus $100 (odds ratio [OR], 14.3 [95% CI, 9.4\u201321.8]) and $50 compared with $100 (OR, 3.6 [95% CI, 2.5\u20135.1]). Overall, participants in the cost\u2010primed group were more willing to take sacubitril\/valsartan than those not primed to consider their financial situation (63% versus 56%,\n              <jats:italic>P<\/jats:italic>\n              =0.04). There was no statistically significant interaction between cost conditions and cost priming. Perceived benefit of sacubitril\/valsartan over angiotensin\u2010converting enzyme inhibitors or angiotensin receptor blockers decreased as cost increased but did not vary by cost priming.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Commonly encountered out\u2010of\u2010pocket costs of sacubitril\/valsartan may impact individuals\u2019 willingness to take the medication even when recommended by their physicians. Priming individuals to consider personal finances before learning about the drug increased willingness to take sacubitril\/valsartan.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.023789","type":"journal-article","created":{"date-parts":[[2022,6,20]],"date-time":"2022-06-20T10:01:14Z","timestamp":1655719274000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Impact of Financial Considerations on Willingness to Take Sacubitril\/Valsartan for Heart Failure"],"prefix":"10.1161","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7593-8533","authenticated-orcid":false,"given":"Birju R.","family":"Rao","sequence":"first","affiliation":[{"name":"Division of Cardiology Department of Medicine Emory University School of Medicine Atlanta GA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Candace D.","family":"Speight","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Emory University School of Medicine Atlanta GA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2540-3095","authenticated-orcid":false,"given":"Larry A.","family":"Allen","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Colorado School of Medicine Aurora CO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott D.","family":"Halpern","sequence":"additional","affiliation":[{"name":"Palliative and Advanced Illness Research (PAIR) Center and Department of Medicine Pennsylvania Perelman School of Medicine Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6543-9765","authenticated-orcid":false,"given":"Yi\u2010An","family":"Ko","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Emory University Rollins School of Public Health Atlanta 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