持续释放皮质类固醇在医疗保险通行计划下用于白内障手术的使用和成本
Xi Dai1, David F Chang2,3, Ariel Chen1,4
1The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
JAMA ophthalmology
|August 3, 2023
概括
对白内障手术的持续释放性皮质类固醇的使用率较低,医疗保健成本增加. 目前的医疗保险退款可能会阻止人们采用这些方便但昂贵的抗炎治疗方法.
科学领域:
- 眼科医生 眼科 眼科
- 卫生经济学 卫生经济学
- 药物经济学 药物经济学
背景情况:
- 持续释放的皮质类固醇可以改善患者的服从性,并为白内障手术后的抗炎治疗提供便利.
- 这些先进的配方比传统的皮质类固醇眼药要贵得多,这是标准的护理.
- 研究期间与这些新型治疗方法的临时医疗保险通行补偿计划相吻合.
研究的目的:
- 评估在美国接受白内障手术的医疗保险受益人中持续释放的皮质类固醇 (德甲眼内悬浮9%,德甲眼科插入剂) 的使用模式.
- 分析这些持续释放配方在医疗保险通行补偿期间的相关成本.
主要方法:
- 一项跨部门研究分析了2019年3月至2021年12月的医疗保险服务费 (FFS) 索赔数据.
- 包括接受过至少一次白内障手术的受益者,不包括特定患者群体和手术当天同时使用皮质类固醇.
- 关于药物使用,外科医生人口统计和医疗保险允许对已识别的持续释放性皮质类固醇的收费的数据被提取和分析.
主要成果:
- 分析了超过425万例白内障手术.
- 只有0.8%的受益者接受了甲眼内悬浮剂,9%,1.7%接受了甲眼科插片.
- 医疗保险允许的平均费用为悬浮剂531.47美元,插入剂538.49美元,与传统眼滴相比,这意味着相当大的成本.
结论:
- 尽管在遵守和方便方面有潜在的好处,但在白内障手术中持续释放的皮质类固醇的使用率很低.
- 与这些产品相关的高成本,可能受到医疗保险的通道定价的影响,可能阻止了它们的采用.
- 目前的医疗保险报销政策可能需要修订,以适当地适应成本,并鼓励使用这些先进的术后治疗.
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