相关实验视频
Updated: Jun 17, 2025

12:08
Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
18.8K
国家对胰岛素成本的自付上限:索赔或利用没有显著增加
Kelly E Anderson1, Nathorn Chaiyakunapruk2, Eric J Gutierrez3
1Kelly E. Anderson (Kelly.E.Anderson@cuanschutz.edu), University of Colorado Anschutz Medical Campus, Aurora, Colorado.
Health affairs (Project Hope)
|August 5, 2024
概括
国家对胰岛素自费支出的上限并没有增加商业保险患者的胰岛素使用. 这可能是因为自费费用往往低于上限金额.
科学领域:
- 卫生经济学 卫生经济学
- 糖尿病管理 糖尿病管理
- 制药政策 制药政策
背景情况:
- 胰岛素对于管理1型糖尿病至关重要,20-30%的2型糖尿病患者使用胰岛素.
- 高昂的胰岛素成本导致约25%的胰岛素使用患者使用不足.
- 超过20个州已经制定了每月的胰岛素自费支出上限 (25-100美元),以解决负担能力问题.
研究的目的:
- 评估州级胰岛素自用支出上限对胰岛素使用的影响.
- 为了确定这些上限是否会影响商业保险人员的药物坚持.
主要方法:
- 使用差异差异分析.
- 这项研究包括33134名年龄在18-64岁之间的商业保险人,他们患有1型或胰岛素治疗的2型糖尿病.
- 数据来源于2018年至21年期间IQVIA PharMetrics数据库的25%样本.
主要成果:
- 国家一级的胰岛素口袋外盖并没有显著增加季度胰岛素索赔.
- 在1型或2型糖尿病患者中,没有观察到胰岛素使用的显著变化.
- 没有增加的原因可能是自付费用经常低于实施的上限金额.
结论:
- 州级对胰岛素自费支出的上限并没有明显增加商业保险入学者的胰岛素使用量.
- 可能需要进一步的研究来探索改善胰岛素获取和负担能力的替代策略.
- 政策影响表明,目前的上限结构可能不足以克服胰岛素使用的成本障碍.
相关概念视频
Insulin: Dosing Regimen and Adverse Effects
162
Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
162
Dipeptidyl Peptidase 4 Inhibitors
180
Dipeptidyl peptidase 4 (DPP-4) is a serine protease widely distributed in the body. It's involved in the inactivation of GLP-1 and GIP hormones, which are crucial for insulin regulation. DPP-4 inhibitors, such as sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), alogliptin (Nesina), and vildagliptin (Galvus), help increase the proportion of active GLP-1, enhancing insulin secretion. These inhibitors work by competitively binding to DPP-4. This binding causes a...
180
Oral Hypoglycemic Agents: Biguanides and Glitazones
185
Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood...
185
Insulin Formulations: Types and Delivery
180
Insulin preparations are categorized by their duration of action into short-acting and long-acting types. Two strategies are used to modify insulin's absorption and pharmacokinetic profile: slowing the absorption post-subcutaneous injection, or altering human insulin's amino acid sequence or protein structure. These changes retain the insulin's ability to bind to the insulin receptor, but alter its behavior in solution or after injection.
Short-acting insulins are divided into...
Short-acting insulins are divided into...
180
Glucagon-like Receptor Agonists
311
Incretins include glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), which stimulate insulin secretion post-meals. In type 2 diabetes, GIP's efficacy is reduced, making GLP-1 a viable drug target. GIP originates from preproGIP.
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
311
Oral Hypoglycemic Agents: Glinides
150
Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively...
150

