独立慈善患者援助计划的财政资格标准和药物覆盖
So-Yeon Kang1, Aditi Sen1, Ge Bai1,2
1Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
JAMA
|August 7, 2019
概括
独立的慈善患者援助计划主要提供共同支付支持,并经常排除没有保险的个人. 覆盖的药物通常比不被这些计划覆盖的药物更贵.
科学领域:
- 健康经济学
- 制药政策
背景情况:
- 独立的慈善患者援助计划 (PAP) 旨在改善患者获得昂贵的处方药.
- 最近的联邦调查质疑它们在增加药品开支和潜在违反反法规中的作用.
- 关于这些PAP的设计,患者资格和药物覆盖范围的信息有限.
研究的目的:
- 检查独立慈善 PAP 的资格标准和药物覆盖范围.
- 分析PPP的特点,包括援助类型,保险和收入资格.
- 为了比较所涉及的药物与未涉及的药物的成本以及昂贵的非专利品牌药物的覆盖.
主要方法:
- 一项描述性的横截面研究分析了2018年6个大型独立慈善机构的274个PAP.
- 包括的患者不仅限于医疗保险受益者.
- 分析的药物包括医疗保险D部分支出仪表板上的药物和高成本的非专利品牌药物.
主要成果:
- 大多数PAP (61%) 仅提供共同支付援助;97%需要保险,不包括没有保险的患者.
- 与癌症相关的药物是最常见的治疗领域.
- 覆盖药物的年平均成本为1157美元,远高于非覆盖药物的367美元.
- 价格昂贵的非专利品牌药物比其仿制药物更为广泛.
结论:
- 大多数独立的慈善医疗保险计划都不涵盖没有保险的患者.
- 医疗保险通常比不包括在保险中的药物更昂贵.
- 这些发现凸显了需要进一步调查药品消费计划对药品支出和合规性的影响.
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