创新保险改善美国患者获得细胞和基因治疗的机会
Rena M Conti1,2, Patrick Demartino3, Jonathan Gruber1,4
1Questrom School of Business, Boston University.
The Milbank quarterly
|January 18, 2025
概括
在美国,覆盖细胞和基因疗法 (CGTs) 的年度成本估计为204亿美元,即每人15.69美元. 需要制定政策来改善CGT覆盖率和患者的负担能力.
科学领域:
- 卫生经济学 卫生经济学
- 生物技术是生物技术.
- 遗传学 是一个遗传学.
背景情况:
- 细胞和基因疗法 (CGTs) 为罕见疾病提供拯救生命的治疗方法.
- 高昂的成本和不确定的结果导致保险公司限制患者的访问,可能会加剧健康差距.
- 再保险是保险公司用来管理高成本索赔的一种工具,但目前的计划可能无法充分覆盖CGT.
研究的目的:
- 估计从2023年至2035年在美国覆盖现有和预期的CGT的每人每年增量成本.
- 根据支付者的类型分析这些成本,包括商业计划和州医疗补助计划.
- 评估再保险费用对整体CGT保险成本的影响.
主要方法:
- 模拟增量年度人均再保险商成本对CGT (2023-2035年).
- 利用已公布的美国CGT支出估计,并假定美国人口为3.3亿.
- 根据当前的CGT再保险费用计算成本,并用状细胞疾病向的CGT来说明.
主要成果:
- 预计在2023-2035年期间,对CGT的年度增量支出将达到204亿美元 (每人15.69美元).
- 预计支出将集中在商业保险计划中.
- 针对状细胞的CGT可能总计高达0.78美元PMPM,主要影响州医疗补助计划;再保险费增加总成本.
结论:
- 预计CGT接入的年度人均成本将集中在商业和州医疗补助计划中.
- 目前的保险政策可能不够覆盖CGT,需要改进政策.
- 强化政策对于改善CGT覆盖率和可负担性至关重要,以确保患者获得医疗服务.
关键词:
医疗补助公司 (Medicaid) 的医疗补助.访问 访问 访问 访问不良选择的不利选择.细胞和基因疗法细胞和基因疗法.保险保险的保险是什么意思再保险再保险是什么意思状细胞疾病是一种状细胞疾病.支出支出支出支出支出支出支出支出国家国家国家国家国家国家.停止损失停止损失的时间更多相关视频
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