在皮肤炎症疾病中获得专业治疗:治疗要求和患者的旅程
Matthew G Bowles1, Autumn D Zuckerman1, Josh DeClercq2
1Vanderbilt Specialty Pharmacy, Vanderbilt University Medical Center, Nashville, TN.
Journal of managed care & specialty pharmacy
|February 6, 2025
概括
牛皮和亚托皮性皮肤炎的步骤治疗要求 专用药物导致治疗准入的重大延迟. 大多数患者最终都会接受专科护理,但往往是由于步骤治疗失败而经过长时间后.
科学领域:
- 皮肤病学 皮肤病学
- 卫生经济学 卫生经济学
- 健康 结果 研究 研究 结果
背景情况:
- 付款人和药房福利管理人员 (PBMs) 使用步骤治疗和配方替代品来控制处方药费用.
- 与这些成本控制措施相关的临床有效性和患者结果需要进一步调查.
研究的目的:
- 评估在接受专用药物治疗之前被要求使用步骤治疗或配方替代品的牛皮 (PsO) 或亚托皮炎 (AD) 患者的药物治疗结果和治疗准入时间表.
主要方法:
- 进行了电子健康记录和专业药房数据的回顾性审查.
- 包括的患者 (N=83) 在2021年1月至2022年6月期间被转介给PsO或AD的特殊药物,但需要使用步骤治疗或配方替代品.
- 主要结果:从最初的转诊到第二次专用药物转诊的时间;次要结果:阶段性治疗失败率和不开始专用药物的原因.
主要成果:
- 接受步骤治疗的患者 (n=62) 经历了由于治疗失败而导致第二次转诊的中位延迟75天,其中60%需要随后的转诊.
- 在没有开始专用药物治疗的患者中,8%受益于步骤治疗,24%失去后续治疗,5%拒绝治疗.
- 被指向配方替代品的患者 (n=21) 获得了快速的专用药物,平均延迟3天.
结论:
- 专用皮肤病药物的强制性步骤治疗显著延迟了获得牛皮和亚托邦皮肤炎适当治疗的机会.
- 虽然大多数患者最终会开始专科治疗,但步骤治疗带来的延迟可能是相当大的.
- 建议进行进一步的研究,以评估步骤治疗任务在特殊药物启动之前的财务和临床影响.
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