Out-of-Pocket Payments for the Fixed-Dose Combination of Hydralazine and Isosorbide Dinitrate (BiDil)
Abstract
Concern exists that African Americans seeking treatment for heart failure cannot afford the fixed-dose combination of hydralazine hydrochloride and isosorbide dinitrate (BiDil). Some physicians therefore have expressed reluctance to prescribe this FDA-approved therapy. A recent study by the National Minority Quality Forum has found that in 2013 the median out-of-pocket payment per tablet by African American Medicare beneficiaries for whom the therapy was indicated was $0.06, and 25% of them had no out-of-pocket expenditure for the medication. Optimal daily dosage is six tablets. Among these eligible patients who were prescribed the optimal dosage, 50% were paying out of pocket $0.36 or less per day and 75% were paying $2.00 or less per day.
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The Lupus Research Alliance (LRA) and the National Minority Quality Forum formed the Lupus Multi-Cultural Engagement Partnership (Lupus MCEP) in 2017 to address the causes and potential solutions for the lack of inclusion in clinical trials of populations that are at greatest risk for and have the highest prevalence of Systemic Lupus Erythematosus (SLE or lupus). The inaugural Lupus MCEP meeting featured presentations from researchers, clinicians, people with lupus, and patient advocates who described the complexity of the Lupus MCEP charge through their particular lenses.