医疗保险对品牌组合药物的支出与其通用成分
Chana A Sacks1, ChangWon C Lee1, Aaron S Kesselheim1
1Program on Regulation, Therapeutics, and Law, Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
JAMA
|August 25, 2018
概括
医疗保险每年可以节省9.25亿美元, 促进仿制药替代为医疗保险药物补贴计划提供了显著的节省机会.
科学领域:
- 健康经济学
- 药物经济学
- 毒品政策
背景情况:
- 品牌组合药物通常比单独的仿制药物成本更高.
- 通过在医疗保险处方中使用通用成分来节省成本的潜力仍然在很大程度上未得到量化.
研究的目的:
- 估计医疗保险因处方品牌组合药物而产生的超额成本.
- 通过通用药物替代来确定医疗保险D部分计划中的潜在节省.
主要方法:
- 对2011-2016年的医疗保险D部分受益者数据进行了回顾性分析.
- 分析的药物包括2015年支出最高的1500种药物,重点是与可用的仿制药或治疗等效成分的品牌组合.
- 通过比较医疗保险对品牌组合的支出与通用成分的估计支出来计算成本差异.
主要成果:
- 在2016年,医疗保险在29种特定的品牌组合药物上花费了大约9.25亿美元,而不是它们的通用成分.
- 在各类药物中发现了显著的潜在节约:相同剂量的仿制药 (23500万美元),不同剂量的仿制药 (21900万美元) 和治疗上相当的替代品 (47100万美元).
- 在五年间 (2011-2016年),如果使用通用成分,前10个最昂贵的组合产品可能会节省约27亿美元.
结论:
- 处方通用成分而不是品牌组合药物为医疗保险提供了大量可量化的节省成本的机会.
- 实施鼓励仿制药替代和治疗互换的政策,加上处方者教育,可以在医疗保险药物福利计划中显著提高财务效率.
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