雇用者の薬物福利計画と処方薬への支出
Geoffrey F Joyce1, José J Escarce, Matthew D Solomon
1RAND Health, 1700 Main St, Santa Monica, CA 90407-2138, USA. gjoyce@rand.org
JAMA
|October 9, 2002
まとめ
医療保険給付の変更は,より高い共同支払いと必須のジェネリック置換などの変更により,雇用者のための薬物支出を大幅に削減しました. しかし,これらの変更により,受益者の自費費が増加し,財政的負担がシフトしました.
科学分野:
- 健康経済学とは
- 医薬品政策について
- 保険給付管理 保険給付管理について
背景:
- 処方薬の支出の増加は,働く年齢の成人に影響を与えています.
- 雇用者と保険会社は,薬物コストをコントロールするために給付変更を実施しています.
- これらのイニシアチブが薬物支出全体に与える影響は不明である.
研究 の 目的:
- 医療保険の利益イノベーションが医薬品コストに与える影響を評価する.
- 多層の配方薬と必須のジェネリック代替薬が保険会社の薬費総額と受給者の自費支出にどのように影響するか分析する.
主な方法:
- 1997年から1999年にかけての請求データを分析した遡及的研究.
- 25の大企業の420,786人の18歳から64歳までの受益者を含め,門診薬剤保険の対象となった.
- 薬の総コスト,ジェネリック医薬品とブランド医薬品の支出,保険会社の支払い,受益者の自費費用を調査した.
主要な成果:
- コペイメントの増額により,会員1人当たりの年間平均薬物コストが22.3% (1階層) と32.9% (2階層) 減少した.
- 2階層の計画におけるジェネリック代用の義務化により,薬物支出は8%減少した.
- 2階層プランでの付与額の増加は,受益者の自費支出を17.6%から25.6%に増加させた.
結論:
- 福利厚生制度の変更は,付加金の増加と必須のジェネリック代用を含むもので,雇用者にとっての薬物支出全体を効果的に削減しました.
- これらのコスト削減は,主に保険プランに利益をもたらした.
- 受益者は,自費薬費の大幅な増加を経験しました.
関連する概念動画
01:17Drug Nomenclature
During the development of a new pharmaceutical, the manufacturer initially assigns a code name to the drug. Once approved, the drug receives a United States Adopted Name (USAN)—a generic, nonproprietary designation. Upon being listed in the United States Pharmacopeia, this nonproprietary name becomes the drug's official name. Additionally, the manufacturer assigns a proprietary name or trademark, which serves as the brand name under which the drug is marketed. It is worth noting that the same...
01:24Rational Dosage Regimen: Maintenance Dose and Loading Dose
A rational dosage regimen considers a drug's pharmacokinetics, including its absorption, distribution, metabolism, and elimination from the body. By understanding these factors, the appropriate dosage can be determined, and the dosing schedule can be designed to achieve and maintain the desired therapeutic effect while minimizing adverse effects.
In most cases, drugs are administered repetitively or infused continuously to maintain a steady-state concentration in the body. At a steady state,...
In most cases, drugs are administered repetitively or infused continuously to maintain a steady-state concentration in the body. At a steady state,...
01:15Drug Dosage Regimen: Overview
A drug dosage regimen describes the specific instructions and schedule for administering a drug to a patient. It considers factors such as drug dosage, frequency, route of administration, and duration of treatment. Designing an appropriate dosage regimen for a patient aims to achieve a target drug concentration at the site of action.
Typically, the starting dose and dosing interval are guided by the manufacturer's recommendations based on clinical trials conducted during and after drug...
Typically, the starting dose and dosing interval are guided by the manufacturer's recommendations based on clinical trials conducted during and after drug...
01:02Prescription, Nonprescription and Orphan Drugs
Prescription drugs require a prescription from a medical practitioner and can only be obtained from a pharmacy. They have many applications, including treating pain, anxiety, and hypertension.
The misuse and addiction to prescription drugs is a growing problem that can affect people of all age groups, specifically teenagers. This can happen when prescription medications are used in ways not intended by the prescriber, such as taking someone else's prescription or using medication for...
The misuse and addiction to prescription drugs is a growing problem that can affect people of all age groups, specifically teenagers. This can happen when prescription medications are used in ways not intended by the prescriber, such as taking someone else's prescription or using medication for...
01:28Dosage Regimens: Designs and Approaches
Designing a dosage regimen, which refers to the manner of drug administration, is a complex process involving the selection of drug dose, route, and frequency. This process is underpinned by pharmacokinetic parameters derived from tests and population averages. These parameters are then tailored to patient-specific variables such as diagnosis, demographics, and allergy status. Once therapy commences, therapeutic response monitoring is critical and achieved through clinical and physical...
01:25Determination of Multiple Dosing Parameters: Loading and Maintenance Doses
A loading dose is an essential pharmacological strategy to rapidly achieve the target plasma drug concentration necessary for an immediate therapeutic effect. This approach is especially critical for drugs characterized by slow absorption or extended half-lives, where delaying therapeutic plasma levels could compromise treatment outcomes. By administering a loading dose, clinicians ensure a prompt onset of drug action, even for agents with complex pharmacokinetic profiles.Achieving steady-state...