Inoue, Kosuke, Sérgio R R Decker, Ivy Shi, Lichen Liang, Yang Song, Sadiya S Khan, and Dhruv S Kazi. (2025) 2025. “Discontinuation of Semaglutide Among Older Adults With Diabetes in the US and Japan.”. JAMA Cardiology. https://doi.org/10.1001/jamacardio.2025.3109.
Publications
2025
Kazi, Dhruv S, Abdul R Abdullah, Suzanne Arnold V, Anirban Basu, Brandon K Bellows, Khadijah Breathett, Derek S Chew, et al. (2025) 2025. “2025 AHA/ACC Statement on Cost/Value Methodology in Clinical Practice Guidelines (Update From 2014 Statement): A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.”. Circulation. https://doi.org/10.1161/CIR.0000000000001377.
AIM: The "2025 AHA/ACC Statement on Cost/Value Methodology in Clinical Practice Guidelines (Update From 2014 Statement)" describes a systematic approach for consistent implementation of "economic value statements" across ACC/AHA guidelines. It updates the cost-effectiveness threshold and proposes a new level of certainty framework that summarizes the strength of the available evidence. Additionally, it describes how cost-effectiveness analyses (CEAs) can help advance equity in population cardiovascular health.
METHODS: A focused literature search was conducted from January 9, 2024, to February 2, 2024, encompassing English-language publications related to CEA methodology in PubMed, EMBASE, and the Cochrane Library, with publication dates ranging from 1973 to the present. Additional relevant studies published during the writing process (through June 25, 2024) were also considered by the writing committee.
STRUCTURE: This Cost/Value Methodology Statement updates prior guidance regarding the incorporation of evidence from published CEAs into clinical guidelines. It provides guidance for identifying and synthesizing relevant high-quality evidence, developing economic value statements, and communicating level of certainty in such statements. It defines the US cost-effectiveness threshold as $120 000 per quality-adjusted life year gained, highlights special considerations related to cardiovascular drugs and devices, emphasizes health equity considerations when interpreting CEAs, and defines a reference case for future CEAs.
Kazi, Dhruv S, Abdul R Abdullah, Suzanne Arnold V, Anirban Basu, Brandon K Bellows, Khadijah Breathett, Derek S Chew, et al. (2025) 2025. “2025 AHA/ACC Statement on Cost/Value Methodology in Clinical Practice Guidelines (Update From 2014 Statement): A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.”. Journal of the American College of Cardiology. https://doi.org/10.1016/j.jacc.2025.05.009.
AIM: The "2025 AHA/ACC Statement on Cost/Value Methodology in Clinical Practice Guidelines (Update From 2014 Statement)" describes a systematic approach for consistent implementation of "economic value statements" across ACC/AHA guidelines. It updates the cost-effectiveness threshold and proposes a new level of certainty framework that summarizes the strength of the available evidence. Additionally, it describes how cost-effectiveness analyses (CEAs) can help advance equity in population cardiovascular health.
METHODS: A focused literature search was conducted from January 9, 2024, to February 2, 2024, encompassing English-language publications related to CEA methodology in PubMed, EMBASE, and the Cochrane Library, with publication dates ranging from 1973 to the present. Additional relevant studies published during the writing process (through June 25, 2024) were also considered by the writing committee.
STRUCTURE: This Cost/Value Methodology Statement updates prior guidance regarding the incorporation of evidence from published CEAs into clinical guidelines. It provides guidance for identifying and synthesizing relevant high-quality evidence, developing economic value statements, and communicating level of certainty in such statements. It defines the US cost-effectiveness threshold as $120,000 per quality-adjusted life year gained, highlights special considerations related to cardiovascular drugs and devices, emphasizes health equity considerations when interpreting CEAs, and defines a reference case for future CEAs.
Liu, Michael, Daniel Y Johnson, Sara N Bleich, Prihatha R Narasimmaraj, Camilla Bjorck-Posson, Jose F Figueroa, and Rishi K Wadhera. (2025) 2025. “Changes in Physical and Mental Health After the End of SNAP Emergency Allotments.”. JAMA 334 (2): 175-77. https://doi.org/10.1001/jama.2025.6010.
Marinacci, Lucas X, Michael Liu, Jose Figueroa, and Rishi K Wadhera. (2025) 2025. “Insurance Coverage Among Working-Age U.S. Adults After the End of the Medicaid Continuous Enrollment Provision.”. Annals of Internal Medicine 178 (7): 1057-60. https://doi.org/10.7326/ANNALS-24-03261.
Johnson, Daniel Y, Archana Tale, and Rishi K Wadhera. (2025) 2025. “Prescription Drug Savings With the Expansion of the Out-of-Pocket Spending Cap to Adults With Private Insurance.”. Journal of General Internal Medicine 40 (13): 3295-98. https://doi.org/10.1007/s11606-025-09486-7.
Inoue, Kosuke, Dhruv S Kazi, Muthiah Vaduganathan, and Rishi K Wadhera. (2025) 2025. “Prescription Patterns for GLP-1 Receptor Agonists and SGLT2 Inhibitors by Physicians’ Years in Practice.”. Journal of General Internal Medicine 40 (11): 2807-9. https://doi.org/10.1007/s11606-025-09380-2.
Serpa, Frans, Sudheesha Perera, Daniel E Cruz, Jose F Figueroa, Fatima Rodriguez, Daniel B Kramer, and Rishi K Wadhera. (2025) 2025. “Cardiovascular Health, Lifestyle Factors, and Social Determinants Among Hispanic or Latino Adults in the United States.”. American Heart Journal 285: 133-44. https://doi.org/10.1016/j.ahj.2025.03.002.
BACKGROUND: Among Hispanic/Latino subgroups residing in the US, disparities in cardiovascular health status remain largely uncharacterized.
METHODS: This national study used the National Health Interview Survey to assess the burden of cardiometabolic risk factors (hypertension, hyperlipidemia, obesity, diabetes) and cardiovascular diseases (history of heart attack, coronary heart disease, angina, stroke) across Hispanic/Latino subgroups (Mexican, Cuban, Puerto Rican, Central/South American), and the extent to which differences are related to lifestyle factors (physical inactivity, smoking, and alcohol consumption) and/or social determinants of health (income, education, food security, and health insurance status).
RESULTS: The weighted study population included 35,549,841 Hispanic/Latino adults (26,008 respondents). In age- and sex-adjusted models, hypertension was more common among Puerto Rican adults (OR 1.34, 95% CI: 1.12-1.60) but less common among Central/South American adults (OR 0.71, 95% CI: 0.61-0.82) compared to Mexican adults (reference group). Central/South Americans were also less likely to have obesity (OR 0.63, 95% CI: 0.57-0.70) and diabetes (OR 0.50, 95% CI: 0.42-0.61). For cardiovascular diseases, Puerto Rican adults were more likely to have angina (OR 1.69, 95% CI: 1.06-2.71), whereas Central/South Americans were less likely to have angina (OR 0.50, 95% CI: 0.30-0.84), coronary heart disease (OR 0.70, 95% CI: 0.51-0.96), and heart attack (OR 0.49, 95% CI: 0.33-0.72). Moreover, Cuban adults were less likely to have hyperlipidemia (OR 0.73, 95% CI: 0.61-0.88), obesity (OR 0.58, 95% CI: 0.49-0.70), diabetes (OR 0.44. 95% CI: 0.34-0.57) and stroke (OR 0.54, 95% CI: 0.32-0.92) Differences persisted after sequentially adjusting for lifestyle factors and social determinants of health.
CONCLUSION: This study used disaggregated data to demonstrate the complex landscape of cardiovascular health among Hispanic/Latino adults in the US, emphasizing the need for targeted interventions and policy efforts to reduce health inequities in this rapidly growing population.
Johnson, Daniel Y, Michael Liu, Victoria L Bartlett, ZhaoNian Zheng, Andrew S Oseran, and Rishi K Wadhera. (2025) 2025. “Heart Failure Care and Outcomes After Private Equity Acquisition of U.S. Hospitals.”. Journal of the American College of Cardiology 86 (4): 259-67. https://doi.org/10.1016/j.jacc.2025.05.037.
BACKGROUND: Private equity firms have rapidly acquired U.S. hospitals and increasingly invested in cardiology over the past decade. However, little is known about how private equity acquisition of hospitals affects care and outcomes for patients with heart failure.
OBJECTIVES: The purpose of this study was to evaluate whether clinical care and outcomes changed for patients with heart failure after the acquisition of U.S. hospitals by private equity firms compared with matched control hospitals.
METHODS: This study identified U.S. hospitals acquired by private equity firms and matched control hospitals from 2012 through 2019. A quasiexperimental difference-in-differences analysis was used to evaluate changes in clinical outcomes, the case mix of admissions and transfers, as well as cardiac procedure utilization among Medicare fee-for-service beneficiaries aged 65 years or older with heart failure.
RESULTS: There were 41 private equity-acquired hospitals and 192 matched control hospitals. After private equity acquisition of hospitals, there was no change in 30-day mortality rates (difference-in-differences [DiD] +0.7 percentage points [95% CI: -0.4 to 1.8]) or 30-day hospital revisit rates (DiD -0.2 percentage points [95% CI: -0.9 to 0.5]), despite a significant decrease in the clinical risk of patients with heart failure when compared with those at matched control (nonacquired) hospitals. Overall hospital transfer rates did not change, but Black patients were significantly more likely to be transferred out to another site after private equity acquisition (DiD +7.1 percentage points [95% CI: 0.7-13.4]), a change not observed across other racial groups. In addition, there was a significant increase in cardiac catheterization rates (DiD estimate, +0.7 percentage points [95% CI: 0.1-1.2]) among heart failure patients at private equity-acquired vs control hospitals.
CONCLUSIONS: These findings suggest that private equity acquisitions of U.S. hospitals do not improve outcomes among older adults with heart failure, despite a decrease in the clinical risk of patients admitted to these sites.
Johnson, Daniel Y, Lucas X Marinacci, and Rishi K Wadhera. (2025) 2025. “Hypertension, Diabetes, and High Cholesterol Awareness Among US Adults.”. JAMA Cardiology 10 (8): 859-60. https://doi.org/10.1001/jamacardio.2025.1536.