コスト共有とナロキソン処方箋の配給との関連
Kao-Ping Chua1,2, Rena M Conti3, Pooja Lagisetty4
1Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, University of Michigan Medical School, Ann Arbor.
JAMA
|June 13, 2024
まとめ
ナロキソン (オピオイドの過剰投与を逆転させる薬) の患者のコスト共有の増加は,より高い処方箋放棄率と関連しています. 費用の共有をなくすことで ナロキソンへのアクセスを促進し オピオイドの流行と闘うことができます
科学分野:
- 薬学経済学
- 公衆衛生
- 医療サービス研究
背景:
- アメリカでのオピオイドの流行は オピオイドの過剰摂取を逆転させる薬であるナロキソンへのアクセスを増やすことを必要としています
- 以前の研究によると,患者の費用の共有は,ナロキソン処方箋の配布を妨げる可能性がある.
- 既存の研究は,横断的な設計と放棄された処方箋を追跡する能力によって制限されています.
研究 の 目的:
- 患者の費用の共有とナロキソン処方箋の放棄との関連を調査する.
- ナロキソン処方箋の非配給に対するコスト共有の増加の影響を定量化する.
主な方法:
- 横断的,ぼんやりとした回帰不連続性分析が採用された.
- IQVIA Formulary Impact Analyzer (2020-2021) のデータは,ナロキソン鼻スプレーの薬局取引を記録しています.
- 分析は,1月1日の控除可能なリセット期間周辺の商業保険およびメディケア患者に焦点を当てた.
主要な成果:
- 医療費分担の15ドル増加は 医療費分担の4.7パーセント増加と相関しています
- 医療保険の費用の共有が 12.3 ドル増加すると 放棄率が 2.8 パーセント上昇します
- ナロキソンの費用分担を10ドル引き上げると 放棄率は3.1% (商業用) と2.3% (メディケア) 増加する.
結論:
- ナロキソンの費用分担を廃止すると 投与率が大幅に増加する可能性があります
- オピオイド危機を緩和する鍵となる戦略は,ナロキソンへのアクセスに対する財政的障壁を減らすことです.
- ナロキソン利用の改善には,コスト共有の削減に焦点を当てた政策介入が必要である.
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