高血圧に対するエビデンスベースの処方による経済的影響:より良いケアがより安価になるのか?
Michael A Fischer1, Jerry Avorn
1Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass 02120, USA. mfischer@partners.org
JAMA
|April 22, 2004
まとめ
高齢者のための根拠に基づいた高血圧のガイドラインを遵守することで,処方箋費用で年間1160万ドルを節約できます. 国の貯蓄額は12億米ドルに達し,処方薬の恩恵がより手頃な価格で受けられるようになる.
科学分野:
- 健康経済学 医療経済学
- 薬学経済学 薬学経済学
- ゲリアトリック・メディシン (老年医学)
背景:
- 高血圧の治療は,多くの場合,根拠に基づいたガイドラインから逸脱し,高齢の患者の薬費に影響を与えます.
- サブオプティマルの処方箋は,高額な薬費と,高齢のアメリカ人に手頃な価格で処方薬の恩恵を提供するという課題に寄与しています.
研究 の 目的:
- 高血圧管理ガイドラインの遵守を改善することで得られる医療費の潜在的節約を計算する.
- 65歳以上の患者に焦点を当てます.
主な方法:
- 処方された抗高血圧薬とガイドラインで推奨された抗高血圧薬の比較分析.
- 実際のおよび証拠に基づいた制度のコスト計算.
- 研究人口:133624人の高齢者が,2001年に州製薬支援プログラムに参加しました.
主要な成果:
- 250万冊以上の処方箋を分析し,年間4850万ドルの費用がかかりました.
- 40%の処方箋 (815,316) は,より適切な証拠に基づいた代替案を持っていた.
- ガイドラインを遵守することで,1160万ドル (24%のコスト) の潜在的な節約が可能で,カルシウムチャネルブロッカーの変更により最大の節約が得られます.
結論:
- 根拠に基づいた高血圧処方ガイドラインの遵守は,高齢の患者にとって大幅な処方費コスト削減をもたらすことができます.
- 年間約12億ドルの国民節約が推定されています.
- 処方箋の改善のための分野を特定することは,処方薬の利益プログラムの手頃な価格のために非常に重要です.
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