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By John Schieszer
Medical Minutes 

Drug discount cards; new weight loss med; using augmented reality to improve knee replacements

Medical Minutes


October 1, 2023 | View PDF

Discount cards with Amazon and GoodRx versus out of pocket payments

A nationally representative study is suggesting that at least one out of five prescriptions for commonly prescribed generic medications are cheaper through Amazon Prime or GoodRx Gold discount cards compared to actual out-of-pocket payments made by patients. The authors also highlight the disproportionately higher frequency of out-of-pocket payments exceeding discount card pricing for various vulnerable subgroups like the uninsured and those in the no coverage (deductible) phase.

Researchers from University of Toledo College of Pharmacy and Pharmaceutical Sciences compared out-of-pocket payments obtained from 2020 Medical Expenditure Panel Survey to 2023 counterfactual discount card pricing (Amazon Prime and GoodRx Gold) for 20 commonly prescribed generic medications. They estimated the proportion and extent of out-of-pocket payments exceeding Amazon and GoodRx discount card pricing benchmarks (referred to as “excess OOP payment”). The authors have published their findings in Annals of Internal Medicine.

Results indicate that out-of-pocket payments made by patients exceeded Amazon (20%) and GoodRx (43%) prices for the prescriptions evaluated. The proportion of excess out-of-pocket payment was 40% overall and 79% for prescriptions assumed to be in the no coverage (deductible) phase. Lastly, the estimated cumulative out-of-pocket cost-savings was $969 million with the Amazon discount card and $1.83 billion with the GoodRX discount card.

A new tool in the battle against obesity

A popular weight loss medication may prevent up to 1.5 million heart attacks and strokes over 10 years, and could result in 43 million fewer obese people. Researchers from the University of California, Irvine have just published a study that projects 93 million U.S. adults who are overweight and obese may be suitable for the 2.4 mg dosage of semaglutide, a weight loss medication sold under the name Wegovy.

The study estimated a reduction in cardiovascular disease risk of 1.8% (from 10.15% to 8.34%), projecting up to 1.5 million cardiovascular events could be potentially prevented in 10 years. The study, “U.S. Population Eligibility and Estimated Impact of Semaglutide Treatment on Obesity Prevalence and Cardiovascular Disease Events,” was published in the journal Cardiovascular Drugs and Therapy.

The analysis is based on results from the STEP 1 trial, published in 2021 in the New England Journal of Medicine. It showed the 2.4 mg dosage of semaglutide approved by the FDA for the treatment of obesity reduced body weight by an average of 14.9% along with reductions in several cardiovascular risk factors such as blood pressure and lipids. The study projected 93 million U.S. adults (based on National Health and Nutrition Examination Survey data) who are overweight or obese would fit STEP 1 eligibility criteria and that treatment with the drug would result in 43 million fewer persons with obesity.

“We now have a weight control therapy that also significantly reduces cardiovascular events beyond the diabetes population where it was originally studied,” said lead study investigator Nathan D. Wong, PhD, who is a professor and director of the Heart Disease Prevention Program in the Division of Cardiology at the UCI School of Medicine, Irvine, Calif. “It should be considered for patients who are obese or overweight with other risk factors where cardiovascular disease is their leading cause of disability and death.”

Since drugs in this class have side effects, it is important that patients always discuss the risks and benefits of such therapies with their physician. Additionally, an appropriate dietary and physical activity regimen is always the foundation of weight management and cardiovascular risk reduction. Additionally, Wong noted that given the costs of these therapies, better access is needed for the high-risk underserved populations who may benefit from them.

Augmented reality total knee replacement procedure

Surgeons are now successfully performing a total knee replacement procedure with the assistance of an augmented reality-based surgical platform that was designed with artificial intelligence (AI) and machine learning. Total knee replacement is the most common type of knee replacement.

Arthritis is the most common condition that causes debilitating musculoskeletal pain. Total knee replacement is a successful treatment for advanced knee arthritis. It eliminates much of the pain and restores function. In recent years, augmented reality has become increasingly beneficial in orthopedic surgery, with significant advantages that equip the operating team with the tools to provide a more personalized approach to patient care.

“Augmented reality gives a visualization of the joint that is more dynamic as it is three-dimensional (3D),” said orthopedic hip and knee surgeon Dr. Panagiotis Gikas. “The advanced technology helps with planning the procedure and allows for the best positioning of the implant for each patient during the procedure. The end-result is tailored to the unique anatomy and specific needs of each patient.”

Prior to the procedure, Dr. Gikas used advanced imaging software to visualize the patient’s knee joint in 3D and determine the ideal implant positioning, based on specific anatomy. The virtual 3D model of the patient’s knee helps the surgical team evaluate damaged bone and cartilage so they can plan for the surgery and the optimal placement for the implant.

During the procedure, the physician wears a pair of augmented reality glasses to view the patient’s specific knee anatomy in 3D. Two small sensors are attached to the patient’s leg to provide real-time soft tissue feedback, such as the tension of the ligaments. The AR-based platform enables the surgical team to easily adjust, better visualize and determine the proper placement of the implant given the patient’s specific anatomy, which is key to a successful knee replacement procedure.

John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute. He can be reached at

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John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute.

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