药物使用和支出根据一个由成本效益决定的表格
Kai Yeung1, Maricela Cruz2,3, Emily Tsiao4
1The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, School of Pharmacy, University of Washington, Seattle.
Journal of managed care & specialty pharmacy
|October 27, 2023
概括
基于价值的表单 (VBF-e) 减少了低价值药物使用和医疗计划支出,同时增加了高价值特种药物使用. 成员的自付费用略有上升,但急性护理使用量保持不变.
科学领域:
- 卫生经济学和研究成果研究成果
- 制药政策和管理 制药政策和管理
- 临床药学和药理学 临床药学和药理学
背景情况:
- 美国国家医学院推基于价值的药物配方,以管理医疗保健计划的处方药支出,并确保获得高价值药物.
- 一个"基于价值的表单-基本" (VBF-e) 计划由30个雇主赞助的计划实施,利用成本效益数据指导成本共享和覆盖决策.
研究的目的:
- 评估VBF-e计划对药物使用模式的影响.
- 评估患者自费支出和医疗计划对处方药和其他医疗保健服务的总体支出的变化.
主要方法:
- 从2015年至2019年,采用差异差异队列研究设计,包括1年的随访期.
- 该研究比较了在实施VBF-e的雇主组中注册的个体 (年龄<65岁) 与倾向分数匹配的对照组.
- 测量结果包括手上的药物日 (按VBF-e级别),处方药支出和其他医疗保健利用 (ED访问,医院日,门诊访问).
主要成果:
- VBF-e显著减少了低价值药物的使用 (四级和排除的药物),分别减少了17%和83%.
- 高价值特种药物的使用量大幅增加了123%.
- 医疗保健计划支出减少了14美元,而会员自付支出增加了1美元;其他医疗保健使用保持稳定.
结论:
- 基于成本效益证据的排除表格有效地减少了低价值药物消费,并降低了整体医疗保健计划支出.
- VBF-e计划成功地将药物使用转向高价值的特种药物.
- 实施并没有导致急性护理使用率大幅增加,尽管会员自付费用略有上升.
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