在国家医疗补助计划缓解了接入限制后,使用C型肝炎直接作用抗病毒药物的变化
Sonya Davey1, Kevin Costello2, Massimiliano Russo3
1Program On Regulation, Therapeutics, and Law, Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
JAMA health forum
|April 5, 2024
概括
缓解Medicaid对直接作用抗病毒药物 (DAA) 的覆盖限制显著增加了C型肝炎病毒 (HCV) 治疗. 放松有关肝病严重程度,清醒度和专家准入的规则改善了对这种治疗方法的准入.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 公共卫生 公共卫生
- 卫生政策 卫生政策
背景情况:
- 直接作用抗病毒药物 (DAA) 为C型肝炎病毒 (HCV) 感染提供治疗方法.
- 高成本导致限制性医疗补助覆盖政策,限制患者获得医疗补助.
- 倡导和诉讼促使许多州自2015年以来放松了这些限制.
研究的目的:
- 评估缓解获取限制对DAA在医疗补助受益人处方模式的影响.
- 为了量化在删除或放松覆盖限制后DAA利用率的变化.
主要方法:
- 修改了39个州医疗补助计划的差异分析.
- 从2015年1月1日到2019年12月31日的数据.
- 评估了DAA覆盖范围的限制 (肝病严重程度,物质使用,处方者专业) 使用2014-2022年的数据.
主要成果:
- 7个州在2015-2019年期间取消了限制,25个州放松了限制,7个州维持了限制.
- 每10万受益人每季度的DAA治疗疗程从669增加到3601.
- 减轻的限制与每10万受益人每季度增加966个DAA治疗疗程相关.
结论:
- 放松DAA的覆盖限制导致医疗补助患者中HCV治疗率增加.
- 进一步取消对肝病严重程度,清醒度和处方专业的限制,可以提高对这一至关重要的公共卫生干预措施的获取.
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