340B计划和口服向治疗的高风险处方,用于晚期前列腺癌
Kassem S Faraj1, Mary Oerline1, Samuel R Kaufman1
1Dow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, Michigan.
Urology practice
|August 28, 2024
概括
340B药物定价计划对晚期前列腺癌患者的高风险处方没有影响. 这项研究发现,无论医院是否参与了340B计划,针对性治疗的使用没有差异.
科学领域:
- 在瘤学瘤学.
- 卫生经济学 卫生经济学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 340B药品定价计划为符合条件的医院提供了显著的药品折扣.
- 人们对340B计划中对高风险处方的潜在激励存在担忧.
- 340B计划对晚期前列腺癌的处方模式的影响尚不清楚.
研究的目的:
- 调查参与340B药物定价计划是否会影响针对晚期前列腺癌的口服向药物的高风险处方.
- 为了比较340B参与和非参与医院之间的高非癌症死亡风险患者的向治疗的使用情况.
主要方法:
- 对于患有晚期前列腺癌的男性,医疗保险索赔数据的回顾性分析.
- 主要结局:在非癌症死亡风险高的患者中使用向治疗.
- 二次结果:基于并发症和临死治疗时间的特定抑制剂 (雄激素生物合成,雄激素受体) 的使用.
主要成果:
- 在340B参与与非参与医院的高风险患者中,针对性治疗的使用没有显著差异 (HR 1.1,95% CI 0.67-1.5).
- 基于不同组之间的心脏或神经认知史,使用雄激素抑制剂的比例相似.
- 通过340B参与 (OR1.3,95% CI 0.86-1.9) 在死亡14天内治疗使用没有变化.
结论:
- 在340B药物定价计划中,医院的参与与高级前列腺癌的高风险处方或治疗徒劳性措施的增加无关.
- 调查结果表明,340B计划的激励措施似乎不会在这个患者群体中驱动潜在的不适当的处方.
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