药房福利和慢性病患者使用药物的情况
Dana P Goldman1, Geoffrey F Joyce, Jose J Escarce
1RAND, Santa Monica, Calif 90407-2138, USA. dgoldman@rand.org
JAMA
|May 20, 2004
概括
增加处方药的共同支付大幅减少了许多药物的使用,包括那些治疗慢性疾病的药物. 这种价格敏感性引发了人们对潜在的不良健康结果的担忧,特别是对于糖尿病患者.
科学领域:
- 卫生经济学 卫生经济学
- 制药政策 制药政策
- 临床药房 临床药房 临床药房
背景情况:
- 医疗计划越来越多地使用成本共享来控制药品支出.
- 了解这些成本共享变化对药物使用的影响至关重要.
研究的目的:
- 评估增加成本共享如何影响常见药物类别的利用.
- 在私人保险人和患有慢性疾病的人群中检查这些影响.
主要方法:
- 关联的药房声明和健康计划数据 (1997-2000年) 的回顾性分析.
- 涉及超过528,000名私人保险受益人.
- 检查了在药物供应日上加倍支付付费的影响.
主要成果:
- 双重付款导致8个治疗类别的使用减少,特别是NSAID和抗组胺药.
- 对抗高脂药,抗,抗喘药,抗高血压药,抗抑郁药和抗糖尿病药物观察到显著下降.
- 慢性病患者的药物使用反应较差,尽管在关节炎患者的NSAID和糖尿病患者的抗糖尿病药物中出现了显著的减少.
结论:
- 药物使用,特别是间歇性使用的药物,如NSAID和抗胰岛素药物,对共同支付的变化很敏感.
- 虽然慢性病药物的使用减少较为温和,但观察到显著的价格反应.
- 实质性的共同支付增加可能会导致不利的健康后果,特别是对于糖尿病患者.
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