预先授权和与延迟或停止处方药的关联填充
Michael Anne Kyle1, Nancy L Keating1,2
1Department of Health Care Policy, Harvard Medical School, Boston, MA.
概括
对口服抗癌药物的新事先授权政策显著增加了医疗保险D部分受益人的处方停用和延迟补充. 这些变化可能会造成护理获取障碍.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 瘤学 药房 药房
- 卫生政策分析 卫生政策分析
背景情况:
- 处方药的先前授权 (PA) 要求越来越普遍.
- 对患者获得口服抗癌药物的PA政策的影响尚不清楚.
研究的目的:
- 检查新的事先授权政策与口服抗癌药物的推迟或停止处方填充之间的关联.
- 评估PA对医疗保险D部分受益人药物获取的影响.
主要方法:
- 使用的医疗保险D部分索赔数据从2010年到2020年.
- 比较受益人填充特定的口服抗癌药物之前和之后的PA政策改变他们的计划.
- 采用差异差异和回归分析来评估药物停用和时间到下一个填充.
主要成果:
- 引入PA政策增加了在120天内停止药物使用的几率7.1倍 (aOR,7.1;P <.001).
- 医疗补助政策将下一次处方填充的时间平均增加了9.7天 (P < .001).
结论:
- 对口服抗癌药物的新事先授权政策与更高的停产和延迟患者护理率有关.
- 这些PA政策可能是获得必要的癌症治疗的重大临床障碍.
- 应该考虑放弃PA对于已经建立在药物治疗方案上的患者,以改善坚持.
更多相关视频
10:05Testing the Efficacy of Pharmacological Agents in a Pericardial Target Delivery Model in the Swine
Published on: July 7, 2016
8.3K
06:55Inverse Probability of Treatment Weighting Propensity Score using the Military Health System Data Repository and National Death Index
Published on: January 8, 2020
14.5K
相关概念视频
Pharmacovigilance
843
Post-marketing surveillance is a critical component of pharmaceutical regulation, often uncovering unanticipated adverse drug reactions (ADRs) once a drug is widely used over an extended period.
This process, termed pharmacovigilance, aims to detect, evaluate, and minimize harmful effects related to medication use. The data collection for pharmacovigilance depends on spontaneous reporting systems, where healthcare professionals or patients voluntarily report suspected ADRs.
In some cases, there...
This process, termed pharmacovigilance, aims to detect, evaluate, and minimize harmful effects related to medication use. The data collection for pharmacovigilance depends on spontaneous reporting systems, where healthcare professionals or patients voluntarily report suspected ADRs.
In some cases, there...
843
Prescription, Nonprescription and Orphan Drugs
736
Prescription drugs require a prescription from a medical practitioner and can only be obtained from a pharmacy. They have many applications, including treating pain, anxiety, and hypertension.
The misuse and addiction to prescription drugs is a growing problem that can affect people of all age groups, specifically teenagers. This can happen when prescription medications are used in ways not intended by the prescriber, such as taking someone else's prescription or using medication for...
The misuse and addiction to prescription drugs is a growing problem that can affect people of all age groups, specifically teenagers. This can happen when prescription medications are used in ways not intended by the prescriber, such as taking someone else's prescription or using medication for...
736
Desensitization and Tachyphylaxis
1.8K
Tachyphylaxis is described as a rapid decrease in response to a drug after repeated or continuous administration of the same drug dose. It is a phenomenon where the body becomes less responsive to a particular substance or intervention over time, requiring higher doses or stronger interventions to achieve the same effect. It results from adaptive changes in the body's receptors, signaling pathways, or physiological processes that occur in response to prolonged exposure to a stimulus.
1.8K
Nonlinear Pharmacokinetics: Dependence of Elimination Half-Life and Dose Clearance
153
The elimination half-life and drug clearance of drugs following nonlinear kinetics can vary with dosage. The Michaelis-Menten parameters and drug concentration influence these factors. As the dose increases, the elimination half-life tends to lengthen, resulting in a reduction in clearance and a disproportionately larger area under the curve. The total clearance can be derived from the Michaelis-Menten equation for drugs following a one-compartment model.
A study on guinea pigs examined the...
A study on guinea pigs examined the...
153
Nonlinear Pharmacokinetics: Overview
385
Nonlinear or dose-dependent pharmacokinetics is a phenomenon that occurs when the pharmacokinetic parameters of certain drugs deviate from linear pharmacokinetics at higher doses. These drugs do not follow the expected first-order kinetics, where the rate of drug elimination is directly proportional to the drug concentration. Instead, they exhibit a nonlinear relationship, which can be attributed to several factors.
Nonlinearity can arise due to the saturation of plasma protein-binding or...
Nonlinearity can arise due to the saturation of plasma protein-binding or...
385
Factors Affecting Drug Response: Overview
2.0K
When it comes to infants and young children, they are typically administered smaller doses of medication in comparison to adults. This is primarily because their organ functions still need to fully develop, meaning their bodies are not as efficient at metabolizing or eliminating drugs. Additionally, their blood-brain barrier is more permeable than in adults. As a result, high concentrations of drugs can easily penetrate the central nervous system (CNS), potentially leading to neurological...
2.0K
