面对高成本和临床不确定性:基因治疗的创新支付模式
Caroline Horrow1, Aaron S Kesselheim2
1Caroline Horrow, Brigham and Women's Hospital, Boston, Massachusetts.
Health affairs (Project Hope)
|November 6, 2023
概括
高昂的基因疗法价格挑战了医疗保健支付者. 新的付款模式,如分期付款和基于结果的付款,可以减轻预算影响和临床不确定性,改善患者的获取.
科学领域:
- 卫生经济学 卫生经济学
- 药物经济学 药物经济学
- 基因疗法政策 基因疗法政策
背景情况:
- 基因疗法为患者提供了显著的益处,但也面临着高昂的预付费用.
- 付款人退款的挑战包括巨大的预算影响和关于有效性和持久性的临床不确定性.
研究的目的:
- 开发基因疗法支付机制的分类学.
- 解决补偿方面的挑战,并确保患者平等获得基因疗法.
主要方法:
- 基因治疗支付模式的分类.
- 基于摊销,风险分散和基于绩效的支付的支付模式的分析.
- 讨论美国付款人的优势,挑战和考虑.
主要成果:
- 开发了支付模式的分类,包括分期付款,风险池,再保险,价格-数量协议,支出上限,订阅,基于结果的支付,折扣,担保,基于人口结果的协议以及证据开发的覆盖.
- 支付模式被分为三个主要方法:摊销,风险分散和基于绩效的支付.
- 讨论了每个模式的好处,缺点和对美国纳税人的影响.
结论:
- 替代支付模式对于管理与基因疗法相关的财务和临床不确定性至关重要.
- 实施创新的报销策略可以促进患者更广泛地获得这些变革性治疗方法.
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