料金対サービスメディケアの処方薬支出,2008年から2019年
Stacie B Dusetzina1,2, Haiden A Huskamp3, Xuanzi Qin1
1Department of Health Policy, Vanderbilt University School of Medicine, Nashville, Tennessee.
JAMA
|October 18, 2022
まとめ
継続的に医療保険に加入している受給者の処方薬の支出は,2008年の24%から2019年の27%に増加しました. この増加には,小売り (Part D) と臨床医が投与する (Part B) の薬が含まれています.
科学分野:
- 健康 経済
- 医薬品政策
- メディケア 医療費
背景:
- 処方薬の支出は公衆と政策立案者にとって大きな懸念事項です.
- 以前の分析では,臨床医が投与する薬 (B部) が除外され,または小売費 (D部) に限られたものであった.
- 医療保険の料金対サービス人口におけるパートBとパートDの両方の薬物支出の包括的な影響に関するデータは限られている.
研究 の 目的:
- 処方薬による医療費の割合を推定する.
- 小売 (Part D) と臨床医が投与する (Part B) の両方の処方薬の支出動向を分析する.
- 特定のメディケア集団における薬物支出の包括的な評価を提供するためです.
主な方法:
- 記述的,連続的,横断的な分析は,米国の有料メディケア受給者の20%のランダムサンプルを使用して行われました.
- この研究では,メディケア・アドバンテージの登録者を除き,2008年から2019年まで継続的にパートA,B,Dに登録された受益者を対象とした.
- 薬物の純支出の測定値は,インフレと販売後の割引で調整され,一人当たりの医療費総額の割合として表現されました.
主要な成果:
- 継続的に登録された受益者の一人当たりの医療費は,2008年の16,345ドルから2019年には20,117ドルに増加しました.
- B 部分 の 薬物 の 支出 は 倍 以上 に 増加 し,一人当たりの 支出 は 720 ドル から 1,641 ドル に 増加 し,D 部分 の 純 支出 は 3,122 ドル から 3,477 ドル に 増加 し まし た.
- 処方薬 (パートBとパートDの合計) に占める年間医療費の割合は,2008年の24.0%から2019年の27.2%に増加した.
結論:
- 処方薬は,2019年のD部に登録された有料メディケア受給者の医療費の約27%を占めています.
- この発見は,販売後の割引を考慮しても依然として重要であり,薬の実質的で増大するコストを強調しています.
- この研究は,メディケアにおける処方薬の支出に関する継続的な監視と政策評価の必要性を強調しています.
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