模拟形式排除的影响:特定排除可能影响多少患者?
Anne M Sydor1, Emily Bergin1, Jonathan Kay2
11. Division of Patient-Focused Economic and Policy Research Global Healthy Living Foundation, Upper Nyack, New York, USA.
Journal of health economics and outcomes research
|March 28, 2024
概括
药房福利管理配方经常要求药物替代品,这些药物在医学上不等价,可能会损害数百万患者. 这些强制性变化可能导致不良事件和停止治疗,影响患者的健康结果.
科学领域:
- 药物经济学 药物经济学
- 健康 结果 研究 研究 结果
- 临床药房 临床药房
背景情况:
- 药房福利管理 (PBM) 表单,最初是为了成本效益,现在优先考虑PBM的财务收益.
- 在主要的PBM配方中,很大一部分 (55%) 的强制替代品涉及非等效的活性成分或配方.
- 这些替代品可能不会为患者提供医疗或财务利益.
研究的目的:
- 模拟排除用于心房/静脉血栓栓塞,偏头痛预防和牛皮的新药的影响.
- 估计受表单排除影响的需要非等效替代的患者数量.
- 量化因这些排除而导致的潜在不良事件和治疗中止.
主要方法:
- 在三个治疗领域中模拟排除新药.
- 利用人口数据,美国顶级配方药的市场份额和2021年处方数据.
- 根据已发表的文献估计的不良事件和治疗中止率.
主要成果:
- 潜在的不良事件可能会影响到100万的AFib/VTE患者,90万的偏头痛患者和50万的牛皮患者.
- 停止治疗可能会影响到924,000名AFib/VTE患者,646,000名偏头痛患者和138,000名牛皮患者.
- 非等效的替代物很常见,并对患者产生重大后果.
结论:
- 在目前的配方中,强制性用非等效治疗替代药物很普遍.
- 这些做法给数十万患者带来了严重的负面健康后果.
- 对表单排除的成本效益分析必须包括发病率和死亡率的影响.
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