酒精使用障碍 药物覆盖和利用管理 在医疗补助管理护理计划中
Maureen T Stewart1,2, Sage R Feltus1,2, Christina M Andrews3
1Institute for Behavioral Health, The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts.
JAMA network open
|March 13, 2025
概括
大多数医疗补助管理护理计划 (MCP) 涵盖了治疗酒精使用障碍 (AUD) 的药物,但覆盖差距仍然存在. 删除AUD药物的使用管理可以改善患者的获取和治疗.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 药物治疗 药物治疗
- 成 药物 药物 药物 药物
背景情况:
- 基于证据的酒精使用障碍 (AUD) 治疗方法包括药物治疗,但这些药物未得到充分利用.
- 医疗补助管理护理计划 (MCP) 是成服务的主要支付人,但他们对AUD药物的政策尚不清楚.
- 了解MCP覆盖范围对于改善获得AUD药物治疗的机会至关重要.
研究的目的:
- 描述医疗补助MCPs对AUD药物的覆盖和使用管理 (acamprosate,naltrexone,disulfiram).
- 检查计划特征和国家政策如何影响药物覆盖率.
- 在医疗补助管理护理中识别AUD药物获取障碍.
主要方法:
- 来自241个综合医疗补助MCP的2021年保险福利数据的横截面内容分析.
- 数据包括药物覆盖范围和利用管理要求 (事先授权,数量限制).
- 分析检查了计划特征 (例如,利状况) 与国家政策 (例如,豁免) 和药物保险之间的关联.
主要成果:
- 在2021年,90%的医疗补助MCP至少涵盖了一种AUD药物.
- 覆盖范围因药物不同而有所不同:阿坎普罗沙特 (54.7%),口服纳尔特雷克松 (84.2%),注射纳尔特雷克松 (72.6%) 和迪苏尔菲拉姆 (63.0%).
- 使用管理是不常见的,除了注射性纳尔特雷,它经常有事先授权或数量限制.
结论:
- 医疗保险覆盖的缺口可能会阻碍AUD药物处方的扩大.
- 医疗补助MCP和州可以通过提供全面的覆盖来增强AUD药物使用.
- 减少AUD药物的使用管理策略可以改善患者获得基于证据的治疗.
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