Fluocinonide

Increasing prescription drug costs are a major concern in health care. The literature lacks an up-to-date assessment of US expenditures on topical steroids, one of the most prescribed medications in dermatology.

To characterize trends in Medicare spending and costs per unit of topical steroids and to model potential savings from substitution of the cheapest steroid within each potency class.

This is a retrospective analysis of Medicare Part D Public Use Files, which provides prescription drug expenditure data between 2012 and 2021.

Between 2012 and 2021, Medicare Part D spent $5.7 billion on topical steroids, with generics accounting for 98.3%. While there has been a steady decline since 2015, total annual spending has overall increased by 35.6%, from $322.2 million in 2012 to $437 million in 2021. Inflation-adjusted costs per unit increased for most generic topical steroids, while the rate of change declined with increasing market competition. Medicare had potential savings of $2.4 billion if prescriptions were substituted for the cheapest steroid within each potency class.

The data set represented only 70% to 77% of beneficiaries with Part D plans, excluded manufacturer rebates, and aggregated all drug strengths. We also excluded drugs with proprietary vehicles.

Medicare expenditures on topical steroids have increased in the past decade, primarily driven by rising generic drug costs.

Glucocorticoids possess extensive and potent pharmacol. effects, but their misuse and overuse are widespread concerns.Consequently, the environmental pollution and health hazards associated with their excessive usage cannot be overlooked.There is an urgent need for enhanced removal and a thorough understanding of the environmental and safety risks arising from the overconsumption of these drugs.In this study, a novel F, N-enriched covalent organic framework (designated as TAPT-COF) with high crystallinity was synthesized.TAPT-COF features numerous active sites, including F-F interaction and hydrogen bond interaction sites, along with a high sp. surface area and good thermal stability.These characteristics enable TAPT-COF to serve as an advanced adsorbent for dispersed solid-phase extraction (D-SPE) of glucocorticoids such as fluocinonide acetate, budesonide, and dexamethasone, with adsorption capacities ranging from 146.77 to 228.90 mg.g^-1 .Notably, TAPT-COF exhibits exceptional protein exclusion efficiency, achieving exclusion rates exceeding 95 %.Due to these advantages, TAPT-COF based D-SPE demonstrates strong applicability in the anal. of complex practical samples, including water and plasma, with satisfactory recoveries ranging from 76.48 % to 112.76 %.Compared to a COF (TPB-COF) that lacks a triazine group, TAPT-COF exhibits superior adsorption performance for target glucocorticoids.This is attributed to its ability to provide enhanced electrostatic interactions, as well as the synergistic effects of hydrogen bonding and F-F interactions.Addnl., TAPT-COF displays a low hemolytic activity, indicating its potential for in vivo anal.