新340B计划参与与商业保险支出对门诊生物瘤学药物的支出之间的关联
Jessica Chang1, Pinar Karaca-Mandic2, Sayeh Nikpay1
1Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis.
加入340B药物定价计划的医院在商业保险患者的癌症药物支出更高. 这项研究表明,340B计划可能对药物成本产生意想不到的后果.
科学领域:
- 卫生经济学 卫生经济学
- 制药政策 制药政策
- 瘤学药物管理 药物管理
背景情况:
- 之前的研究将340B药品定价计划的参与与医疗保险支出增加和向富裕地区的扩张联系起来.
- 340B的参与对商业保险患者的支出的影响,因为他们有更高的报销率,仍然不太了解.
研究的目的:
- 调查340B药物定价计划参与与商业保险患者门诊治疗瘤药物的支出之间的关联.
- 为了利用"负担得起的医疗保健法案"扩大340B的资格标准来分析这一关联.
主要方法:
- 采用了均衡的小组医院队列研究设计,包括2007年至2019年的新和从未参加340B计划的参与者.
- 描述性分析检查了常见的门诊癌症生物药物的支出趋势 (贝瓦西祖马布,菲尔格拉斯蒂姆,佩格菲尔格拉斯蒂姆,利图西马布,特拉斯图祖马布).
- 一个差异模型评估了总药物事件支出的变化,控制了各种因素.
主要成果:
- 这项研究分析了478家医院的95,127次发作. 新的340B参与医院往往是小的和农村.
- 在340B参与开始后,与非参与者 (P = .001) 相比,总发作药物支出显著增加了4074.69美元 (P = .001).
- 早些时候的参与者表现出不太可能增加情节支出,这表明异质效应.
结论:
- 新的340B计划参与与商业保险患者的瘤药物事件支出在统计学上显著增加有关.
- 这些发现引发了人们对340B计划对该人口中药物总支出的潜在意外后果的担忧.
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