成本共享与纳洛处方之间的关联
Kao-Ping Chua1,2, Rena M Conti3, Pooja Lagisetty4
1Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, University of Michigan Medical School, Ann Arbor.
JAMA
|June 13, 2024
概括
增加纳洛 (一种阿片类药物过量逆转药物) 的患者成本与更高的处方戒断率有关. 消除成本共享可能会促进纳洛的获取并打击阿片类药物流行.
科学领域:
- 药物经济学
- 公共卫生
- 医疗服务研究
背景情况:
- 美国阿片类药物流行需要增加对阿片类药物过量逆转药物纳洛的获取.
- 之前的研究表明,患者的费用共享可能会阻碍纳洛处方.
- 现有研究受到横截面设计和无法追踪废弃处方的限制.
研究的目的:
- 调查患者共享费用与放弃纳洛处方之间的关联.
- 量化增加成本共享对纳洛处方不发放的影响.
主要方法:
- 使用横截面模糊回归不连续性分析.
- 来自IQVIA表单影响分析器 (2020-2021) 的数据记录了纳洛鼻喷雾的药房交易.
- 分析的重点是1月1日可扣除的恢复期附近的商业保险和医疗保险患者.
主要成果:
- 对于商业保险患者来说, 分享费用增加了15.0美元, 与放弃率上升了4.7个百分点.
- 医疗保险患者的费用共享增加了12.3美元, 与离职率上升了2.8个百分点.
- 假设纳洛费用增加10美元,可能会使放弃率增加3.1% (商业) 和2.3% (医疗保险).
结论:
- 消除纳洛的成本共享可能会大大提高其发放率.
- 减少纳洛获取资金障碍可能是缓解阿片类药物危机的关键策略.
- 政策干预的重点是降低成本共享,以改善纳洛的可用性.
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