医疗保险D部分保护类政策与较低的药品折扣有关
Pragya Kakani1, Michael Anne Kyle2, Amitabh Chandra3
1Pragya Kakani (pka4006@med.cornell.edu), Cornell University, New York, New York.
Health affairs (Project Hope)
|October 7, 2024
概括
医疗保险D部分保护类具有较低的药物排除率,但也较低的折扣,特别是对于高市场份额的药物. 这种政策可能会限制谈判并增加总体支出.
科学领域:
- 卫生经济学 卫生经济学
- 制药政策 制药政策
- 公共卫生 公共卫生
背景情况:
- 医疗保险D部分计划面临限制,将药物排除在六个受保护类别之外.
- 这种限制可能会阻碍折扣谈判,并导致医疗保健支出增加.
研究的目的:
- 检查保护类地位与2011-2019年医疗保险D部分的表单覆盖和折扣之间的关联.
- 将这些趋势与商业保险计划进行比较.
主要方法:
- 分析美国一级估计的折扣和表单覆盖率数据.
- 医疗保险D部分和商业计划中受保护与未受保护的药物类别的比较.
主要成果:
- 与非受保护类别相比,受保护类别在Medicare Part D中表单排除率明显较低.
- 排除率的差异在医疗保险D部分比商业计划更为明显.
- 在2011-2019年期间,美国水平的平均折扣在受保护类中增长较小 (22.5个百分点),而不是在非受保护类中.
- 与非受保护类相比,具有高医疗保险市场份额的受保护类药物的折扣特别低.
结论:
- 医疗保险D部分保护类政策似乎与降低退款增长有关.
- 这种政策可能会限制计划谈判回扣的能力,可能会影响整体支出.
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