医院价格的医生管理的药物为患者与私人保险的医生
James C Robinson1, Christopher Whaley1, Sanket S Dhruva1
1From the University of California, Berkeley, Berkeley (J.C.R.); Brown University, Providence, RI (C.W.); and the University of California, San Francisco, School of Medicine, San Francisco (S.S.D.).
The New England journal of medicine
|January 24, 2024
概括
医院显著提高药品价格,特别是那些符合340B药品定价计划的药品,保留了癌症和自身免疫药物的保险支出很大一部分.
科学领域:
- 卫生经济学 卫生经济学
- 制药政策 制药政策
- 在瘤学瘤学.
背景情况:
- 医院在制药供应链中发挥着关键作用,影响药品定价和支出.
- 了解药品定价加价对于分析医疗保健成本和保险公司支出至关重要.
研究的目的:
- 量化医院对医生管理的药物的价格加价和保留药物支出.
- 为了比较340B药品定价计划的符合条件和不符合条件的医院和独立医生实践之间的加价.
主要方法:
- 2020-2021年全国蓝十字蓝盾索赔数据对患有瘤,炎症或血细胞缺陷疾病的患者的分析.
- 价格加价的衡量方法是作为回报与收购价格的比率.
- 通过340B药物定价计划评估收购价格的降低.
主要成果:
- 符合340B折扣的医院的中位价格加价为3.08%.
- 与医生实践相比,在340B资格医院的 Markups 是医生实践的6.59倍.
- 医院保留了64.3%的保险公司药品支出 (340B-符合条件) 与44.8% (不符合条件) 与19.1% (医生实践).
结论:
- 医院对私人保险患者的医生处方药物施加了大量的价格加价.
- 340B药品定价计划显著扩大了符合条件的医院的价格加价.
- 提供者组织保留了保险公司药品总支出的很大一部分.
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