New study finds the skyrocketing cost of drugs in U.S. used to treat hookworm and other soil-transmitted parasites increases patient costs, suggests decreased quality of care
A new study finds that the increasingly high prices in the United States of the drugs used to treat three soil-transmitted helminth infections--hookworm, roundworm (ascariasis), and whipworm (trichuriasis)--is not only the major driver for the increase in costs to patients with either Medicaid or private insurance, but it also may have a damaging impact on the quality-of-care patients receive as clinicians shift their prescribing patterns to more affordable yet less-effective medicines covered by insurance.
The drugs of choice recommended by the Centers for Disease Control for treating these infections--albendazole and mebendazole--have seen some of the highest price increases of drugs on the U.S. market. There are limited alternative drugs available.
The peer-reviewed study was published this week in the American Journal of Tropical Medicine and Hygiene (AJTMH) by a team of social scientists and infectious disease experts at the U.S. Centers for Disease Control (CDC), the University at Albany - SUNY, Northeastern University, HealthPartners Institute, and the University of Minnesota.
The percentages of patients prescribed the appropriate standard of care treatment with private insurance for all three infections during the study period was consistently less than 70%, and in the case of hookworm diagnosed in those with private insurance, less than 30% of patients received the standard of care prescription drug. This rate of appropriate treatment is disturbingly low. "
Study Researchers, American Journal of Tropical Medicine and Hygiene
While these neglected parasitic worm infections are relatively uncommon across the U.S., there are pockets where the diseases are more prevalent, particularly rural areas with limited plumbing and poor sanitation. A study published in 2017 in AJTMH found that more than one in three people sampled in a poor area of Alabama tested positive for traces of hookworm, a gastrointestinal parasite though to have been eradicated from the U.S. decades ago.
Joo, H., et al. (2021) The Effect of Drug Pricing on Outpatient Payments and Treatment for Three Soil-Transmitted Helminth Infections in the United States, 2010–2017. American Journal of Tropical Medicine and Hygiene. doi.org/10.4269/ajtmh.20-1452.