专用药物的商业覆盖面,2017-2021年
Julia A Rucker1, Molly T Beinfeld1, Nola B Jenkins1
1Tufts Medical Center, Center for the Evaluation of Value and Risk in Health, Boston, MA 02111, United States.
Health affairs scholar
|May 17, 2024
概括
卫生计划在2017年至2021年期间越来越多地限制了获得特种药物的机会. 政策变得与食品和药物管理局 (FDA) 标签指示不太一致,更多的计划规定了更严格的覆盖要求.
科学领域:
- 卫生政策 卫生政策
- 药品的获取方式 药品的获取方式
- 使用药物使用药物.
背景情况:
- 医疗计划利用覆盖政策来管理注册者获得特殊药物的机会.
- 了解这些政策的趋势对于患者获得药物的准入至关重要.
研究的目的:
- 评估随着时间的推移,医疗保险政策对特殊药物的严格性发生的变化.
- 将健康计划政策与食品和药物管理局 (FDA) 标签指示进行比较.
主要方法:
- 分析了美国17个大型商业医疗保险计划中187种特种药物的保险政策.
- 从2017年到2021年收集的数据.
- 评估政策是否与FDA批准的适应症相一致.
主要成果:
- 与FDA标签一致的政策比例从2017年的57.1%下降到2021年的45.1%.
- 在研究期间,比FDA标签更严格的政策从39.5%增加到51.7%.
- 覆盖排除率保持稳定,约为3.3%.
结论:
- 随着时间的推移,专用药物的健康计划政策变得更加严格.
- 这一趋势表明,患者获得指导方针指示的特殊药物的潜在障碍.
- 在不同健康计划的政策趋势中存在变化.
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