処方薬 の 高額 な 費用 を 乗り切る ため の 策
Hussain S Lalani1,2, Catherine S Hwang1,2, Aaron S Kesselheim1,2
1Program on Regulation, Therapeutics, and Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
JAMA
|October 21, 2024
まとめ
多くのアメリカ人は高額な処方薬の費用に直面し 健康に悪影響を及ぼしています 医療従事者は 共同支払いカードや 援助プログラムなどの戦略を使って 患者さんの薬費を支える手助けをすることができますが システム上の問題は 依然として存在します
科学分野:
- 健康 経済
- 医薬品政策
- クリニック・プラクティス
背景:
- 高い処方薬のコストは 薬物不服と健康への悪影響を 引き起こします
- 処方医と医療従事者は 患者を支援するコスト削減戦略の知識が必要です
- 患者の経済的障壁を理解することは 効果的な薬剤管理に不可欠です
研究 の 目的:
- 処方薬の購入を助ける戦略を 検討し評価する.
- 医療従事者が患者の保険と薬の種類に基づいて適切なコスト削減策を選択するための枠組みを開発する.
- 医療従事者に処方箋費用の補助金について知らせる
主な方法:
- 7つのコスト支援戦略の体系的なレビュー:共同支払いカード,患者支援プログラム,薬局クーポン,直接消費者向け薬局,公共援助プログラム,国際オンライン薬局,およびリアルタイム処方箋のメリットツール.
- 患者プロファイル (保険,薬物タイプ) に対応する戦略を臨床医に指図するためのアルゴリズムの開発
- 各戦略の利点と限界の分析
主要な成果:
- コペイメントカードは 民間保険の患者さんで ブランドの薬を服用している患者さんには 利益をもたらします
- 患者と公共の援助プログラムは,経済的基準を満たす未保険者または公的保険者のための選択肢です.
- 薬局クーポンと直接販売薬局は,すべての患者にとって,特にジェネリック薬の節約の可能性を備えていますが,控除額には含まれていません.
- 国際薬局は,特定のブランド薬のニーズのための最後の手段として機能します.
- リアルタイムで処方箋を出すツールは 費用の見積もりや 保険のある患者のための代替案を見つけるのに役立ちますが 精度は異なります
結論:
- 既存の戦略は 臨床医が患者さんに 薬の購入を助けるための 実践的な解決策を提示しています
- 現在の制度は,米国の処方薬市場におけるより広範な課題を反映し,手頃な価格でのアクセスを妨げています.
- これらの戦略は,直接的なコストバリアに対処しますが,高い医薬品価格の根本的な原因を解決しません.
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