340B药品定价计划的结果:一个范围审查
Ryan P Knox1,2, Junyi Wang2, William B Feldman2,3
1Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, Massachusetts.
340B药品定价计划有利于医疗保健提供者和患者,但对制造商造成成本. 建议增加透明度和监管监督,以确保该计划满足其对服务不足的人群的目标.
科学领域:
- 卫生经济学 卫生经济学
- 制药政策 制药政策
- 获得医疗保健 获得医疗保健 获得医疗保健
背景情况:
- 340B药品定价计划要求为服务于低收入人群的安全网提供者提供折扣药品价格.
- 该计划的扩展导致了越来越多的审查和要求改革.
研究的目的:
- 对有关340B计划的基础和成果的现有文献进行范围审查.
- 确定与该计划相关的关键利益相关者,财务影响和患者利益.
主要方法:
- 在多个数据库 (PubMed,Embase,EconLit,NBER,Westlaw) 和政府网站上进行了全面的文献搜索.
- 包括同行评审的文章,法律出版物,意见稿和公布到2023年2月的政府报告.
- 从900份初始记录中选择了289份文件,重点关注四个利益相关者群体:所涉及的实体,药房,制造商和患者.
主要成果:
- 医院,诊所和药房报告从340B种药物获得收入,而制造商则损失了收入.
- 关于被覆盖实体如何利用3.4亿美元的收入的证据是混合的,一些研究表明服务扩张,另一些研究表明扩张到收入更高的地区.
- 患者获得医疗保健服务的机会有所改善,但有关患者直接节省成本的证据仍然不一致. 在被覆盖实体的审计中发现了较低的合规率.
结论:
- 340B计划为医疗保健提供者提供了财务优势,并提高了患者获得护理的机会,尽管对制药厂商来说成本很大.
- 收入利用的缺乏透明度和不一致的合规性带来了挑战.
- 提高HRSA的透明度和加强监管执法对于该计划的完整性和有效性至关重要.
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