広くカバーされている薬剤と,Medicare Part Dの処方箋の薬剤のカバー範囲の違いを特定する
Chien-Wen Tseng1, Carol M Mangione, Robert H Brook
1Department of Family Medicine and Community Health, John A. Burns School of Medicine at University of Hawaii, Honolulu, USA. cwtseng@hawaii.edu
JAMA
|June 21, 2007
まとめ
ほとんどのメディケア・パートD医薬品は,高血圧,高脂血症,うつ病に対する広くカバーされたジェネリックオプションを提供しています. 臨床医は,広く利用可能な薬がほとんどないため,ブランド薬の適用範囲を確認する必要があります.
科学分野:
- 医療サービス 研究 医療サービス
- 薬学経済学 薬学経済学
- 臨床薬局 臨床薬局について
背景:
- メディケア・パートDのプランには,非常に変動する配方があり,臨床医の薬物保険の決定を複雑にします.
- 広くカバーされている医薬品を特定することは,さまざまなパートDプランの下で患者のケアを管理するために不可欠です.
研究 の 目的:
- カリフォルニアとハワイのメディケアPart D製剤が,主要な治療クラスで少なくとも1つの"広くカバーされている"医薬品を提供しているかどうかを評価する.
- 高血圧,高脂血症,うつ病に対する広くカバーされている医薬品の利用可能性を決定する.
主な方法:
- カリフォルニア州72件,ハワイ州43件のメディケア・パートDの処方箋をメディケア.govのウェブサイト (2006年3月~4月) で分析した.
- ACE阻害剤,ARB,β阻害剤,カルシウムチャネル阻害剤,ループ利尿剤,SSRI,スタチン,チアジド利尿剤を含む8種類の薬剤の適用範囲の評価.
- "幅広くカバー"とは,共同支払い額が35ドル以下で,事前の承認がない場合,formulariesの≥90%に含まれていることと定義されます.
主要な成果:
- 調べられた8つの薬物クラスのうち7つのクラスは,カリフォルニアの処方箋で少なくとも1つの広範にカバーされた薬物を持っていた.
- 広くカバーされている医薬品の45%がジェネリックであり,すべてのジェネリック医薬品の73%が広くカバーされており,ブランド医薬品の6%しかカバーされていない.
- ハワイでも同様の結果が見られ,両州で一貫したパターンが認められた.
結論:
- 処方箋の大きな違いがあるにも関わらず,ほとんどの主要な治療クラスは,広くカバーされている薬,主にジェネリックを含む.
- 臨床医は,すべてのジェネリック医薬品が広くカバーされているわけではないことと,ブランド医薬品のカバーが限られていることを認識する必要があります.
- 臨床医が患者へのアクセスを確保し,処方箋を効果的に管理するために,薬の適用範囲を確認することが不可欠です.
関連する概念動画
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...
01:01Dosage Regimen: Fixed Dose
Fixed-dose regimens are a common approach to administer drugs to achieve and maintain desired levels of the drug in the body. In this dosing strategy, a specific amount of medication is given at regular intervals, often multiple times a day, to ensure a consistent drug concentration in the bloodstream.
Fixed-dose regimens can be used for various routes of administration, including intravenous (IV) injections and oral medications. For IV administration, a predetermined amount of the drug is...
Fixed-dose regimens can be used for various routes of administration, including intravenous (IV) injections and oral medications. For IV administration, a predetermined amount of the drug is...
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...
01:28Drug Products: Biologics, Biosimilars and Interchangeables
Biologics, derived from living sources such as humans, animals, or microorganisms, represent a significant category of pharmaceuticals. These complex molecules, developed through advanced biotechnological methods or purified from natural sources, include essential medical treatments like insulin and growth hormones. The complexity of biologics arises from their large molecular structures and the intricate processes required for their production, making them distinct from conventional...
01:24Dosage Regimen: Individualization
Individualization in dosing regimens is the customization of medication doses for individual patients. Its necessity arises from the goal of maximizing therapeutic benefits while minimizing risks. This approach is pivotal because human responses to drugs can vary widely; what is effective for one person may be inadequate or excessive for another. Interpatient (intersubject) variability refers to differences in drug responses between individuals, while intrapatient (intrasubject) variability...
01:15Drug Dosing: Geriatric Patients
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...