为什么Mirabegron没有被选为CMS谈判计划的第一年?
Lauren A Cadish1, Jonathan P Shepherd2
1Los Angeles General Medical Center and University of Southern California, Los Angeles, CA.
Urogynecology (Philadelphia, Pa.)
|January 14, 2025
概括
米拉贝格伦差点没有被纳入医疗保险节省成本计划. 从抗胆固醇药物转向mirabegron的小转变可以确保其未来的价格下降.
科学领域:
- 老年人药理学 老年人药理学
- 卫生经济学 卫生经济学
- 制药政策 制药政策
背景情况:
- 过度活性膀 (OAB) 药物,主要是抗胆固醇药物,由于痴呆风险,不建议老年人服用.
- 贝塔3激动剂是首选的替代品,但成本往往限制了患者的获取.
- 作为β-3激动剂的米拉贝格伦符合医疗保险/医疗补助服务中心 (CMS) 2023年药物谈判计划 (DNP) 的资格,但未被选中.
研究的目的:
- 分析Mirabegron被排除在2023年CMS DNP之外的原因.
- 估计从抗胆固醇剂到mirabegron的必要转化率,以包括DNP.
主要方法:
- 使用2017-2021年公开数据建模了2023年CMS DNP选择过程.
- 确定了成本最高的药物,排除了不符合条件的药物,并将剩余的药物归类为选择或不选择DNP.
- 基于价格通胀和利用趋势,预计非选择药物的2023年成本.
主要成果:
- 2021年,Mirabegron被列为第九大最昂贵的合格药物,几乎达到了DNP选择的门.
- 它的预计2023年成本为第10代最昂贵药物的96.7%.
- 仅仅1.2%的抗胆固醇药物处方转换为mirabegron,就会使其符合DNP的资格.
结论:
- 米拉贝格朗被排除在2023年DNP之外,突出了一个困境:当前使用不足阻止了降价,这反过来限制了使用.
- 未来将其纳入DNP可以显著降低mirabegron的成本,这可能会导致Medicare受益者从抗胆固醇药物转向抗胆固醇药.
- 这项分析强调了药品定价和谈判计划对弱势群体药物获取和服药的影响.
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