医疗保险与医疗补助支出在CFTR调节器治疗中的趋势 - - 经济评估
Wanjae Cho1, Michael D Parkins2, Christina S Thornton3
1Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary AB Canada.
概括
在医疗保险和医疗补助中,在 2015-2022 年期间,在囊性纤维化转膜导电性调节器 (CFTR) 调节器上的支出显著增加,这是由于新的三重组合疗法所推动的. 与医疗保险相比,医疗补助一直显示出更高的利用率和支出.
科学领域:
- 药物经济学 药物经济学
- 卫生政策 卫生政策
- 肺部病理学 肺部病理学
背景情况:
- 囊性纤维化转膜导电调节器 (CFTR) 调节器彻底改变了囊性纤维化治疗的方法.
- 这些向治疗的高成本给患者和医疗保健系统带来了巨大的财务负担.
研究的目的:
- 分析2015年至2022年CFTR调节器的医疗保险和医疗补助支出趋势.
- 确定CFTR调节器疗法支出增加的主要驱动因素.
主要方法:
- 对医疗保险和医疗补助申请数据 (2015-2022) 的回顾性分析.
- 结果指标包括剂量单位,索赔数,每索赔支出和总支出.
- 计算所有结果指标的年平均百分比变化 (AAPC).
主要成果:
- 医疗补助在剂量单位,索赔数,每索赔支出和总支出方面始终超过医疗保险.
- 医疗补助 (AAPC 38.9%) 和医疗保险 (AAPC 39.2%) 的总支出显著增加.
- 2019年后,随着三重组合疗法 (elexacaftor/tezacaftor/ivacaftor) 的引入,支出加快了,这与减少使用旧药物的同时.
结论:
- 由于新的组合疗法,CFTR调节器支出大幅增加,特别是在2019年之后.
- 医疗保险对CFTR调节器的财务影响比医疗保险更大.
- 调查结果可以为未来的医疗保健系统谈判,政策决策和有关CFTR调节器成本的利益相关者战略提供信息.
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