使用和支出与预防性药物清单用于高扣除健康计划中的喘药物
Anna D Sinaiko1, Dennis Ross-Degnan2, J Frank Wharam3,4
1Department of Health Policy & Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
JAMA network open
|August 29, 2023
概括
预防性药物清单 (PDL) 增加了高扣除健康计划与健康储蓄账户 (HDHP-HSA) 的患者对喘控制药物的坚持. PDLs改善了药物获取和负担能力,而不会恶化临床结果.
科学领域:
- 卫生经济学 卫生经济学
- 医疗保健服务研究 医疗服务研究
- 药物经济学 药物经济学
背景情况:
- 带有健康储蓄账户 (HDHP-HSA) 的高扣除健康计划可以阻止必要的医疗保健利用.
- 预防性药物清单 (PDLs) 豁免了某些药物免税,这可能会提高可负担性.
- PDLs对喘药物坚持和HDHP-HSAs的结果的影响尚不清楚.
研究的目的:
- 评估喘药物PDL与使用,不良结果和患者支出的相关性.
- 评估PDL对HDHP-HSA注册的喘患者的影响.
主要方法:
- 一项使用国家商业健康保险索赔数据 (2004-2017年) 的病例控制研究.
- 与患有喘的患者进行了比较,这些患者从具有PDL的HDHP-HSA过渡到没有PDL的匹配组.
- 根据人口统计数据,喘严重程度进行控制,并按社区收入分层;分析从2020年10月到2023年6月进行.
主要成果:
- PDLs与控制药物的填充量增加有关,包括组合吸入性皮质类固醇/长效β2激动剂 (ICS-LABA) 疗法.
- 在PDLs中观察到,ICS-LABA药物覆盖日数的比例增加.
- PDL与喘护理的自费支出减少有关,而喘恶化情况没有显著变化.
结论:
- 通过PDLs减少喘药物的成本共享,增加了对控制药物的坚持,特别是ICS-LABAs.
- 在这个队列中,PDL似乎与改善的临床喘结果无关.
- PDLs代表了一个潜在的策略,以提高HDHP-HSA注册人员的喘护理的获取和负担能力.
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