美国商业保险人PrEP辅助服务的自付费用,2017-2022年
Ya-Lin A Huang1, Rupa R Patel1, Laura M Mann1
1Division of HIV Prevention, Centers for Disease Control and Prevention.
尽管"负担得起的医疗保健法" (ACA) 规定没有成本共享,但许多个人仍然为HIV暴露前预防 (PrEP) 服务承担了自付费用 (OOP). 需要采取进一步行动,以确保平等地获得这一至关重要的预防性护理.
科学领域:
- 卫生经济学 卫生经济学
- 公共卫生 公共卫生
- 预防艾滋病毒 预防艾滋病毒
背景情况:
- 评估了与艾滋病毒暴露前预防 (PrEP) 相关服务的年度自费 (OOP) 费用.
- 专注于美国商业保险的个人.
- 在"平价医疗法案" (ACA) 授权2021年不进行成本共享之前和之后检查的成本.
研究的目的:
- 评估PrEP服务对保险人员的财务负担.
- 了解ACA没有成本共享授权对PrEP可访问性的影响.
- 为了确定 PrEP 的 OOP 成本的趋势和差异.
主要方法:
- 使用大型商业保险数据库 (2017-2022).
- 已识别的18岁以上的个人处方了PrEP.
- 分析了使用CPT代码进行PrEP相关服务的医疗索赔,计算了OOP成本和趋势.
- 检查了OOP成本和患者人口统计数据之间的关联.
主要成果:
- 从2019年至2022年,观察到OOP成本对辅助PrEP服务的下降趋势.
- 在2022年,OOP费用为提供者访问 (54.18美元) 支付了65.6%的费用,HIV检测 (14.3%的费用) 为26.06美元,肌素检测 (32.5%的费用) 为6.07美元.
- 农村居民比城市居民更容易承担费用.
结论:
- 尽管ACA授权,但PrEP使用者的很大比例承担了OOP成本.
- 需要对计费和编码进行标准化,以改善获得预防性护理的机会.
- 加强监测和执法对于保护获得基于证据的艾滋病毒预防至关重要.
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