在退伍军人事务和医疗保险部门使用多发性硬化症疾病修饰疗法:比较分析
Daniel M Hartung1, Glenn D Graham2, Mitchell Wallin3
1Oregon Health & Science University, Portland, OR, USA; Oregon State University, Corvallis, OR, USA.
Multiple sclerosis and related disorders
|November 26, 2024
概括
对多发性硬化症 (MS) 的疾病修饰疗法 (DMT) 的使用在VA和医疗保险中类似,但年轻的VA患者接受了更多的治疗. 此外,VA还使用更多高效的DMT,可能减少残疾和成本.
科学领域:
- 神经学 神经学
- 医疗保健服务研究 医疗服务研究
- 药物经济学 药物经济学
背景情况:
- 多发性硬化症 (MS) 的高成本疾病修饰疗法 (DMT) 对患者 (PwMS) 和支付人来说构成负担能力挑战.
- 退伍军人事务部 (VA) 通过各种策略来管理MS DMT的使用和成本.
- 这项研究比较了VA和美国医疗保险计划之间的国家MS DMT利用趋势.
研究的目的:
- 为了比较国家在VA和医疗保险计划中MS DMT的使用趋势.
- 确定这些大型联邦医疗保健系统如何管理DMT使用的差异.
- 在这些系统中分析PwMS中的人口统计和DMT使用模式.
主要方法:
- 在VA和医疗保险中使用的PwMS从2012-2021年处方DMT的计数.
- 对于每个疗法,DMT使用者的估计年份比例.
- 在VA和医疗保险队伍之间比较使用趋势,人口统计和DMT使用情况.
主要成果:
- 总体而言,DMT的使用是可比的 (VA:65.9%,医疗保险:69.7%).
- 年轻的PwMS (<50岁) 在VA (85.8%) 与医疗保险 (76.9%) 之间显示出更高的DMT流行率.
- 高效的B细胞耗尽DMT的使用在VA中始终更高.
- 在医疗保险中,通用DMT的采用率低于预期.
结论:
- 在年轻的VA患者中,增加DMT的使用和更高效的药物的利用可能会降低残疾和医疗保健成本.
- 在医疗保险中更低的通用DMT采用值得进一步调查.
- 未来的研究应该将DMT的使用,成本和这些人群的健康结果联系起来.
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