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胰岛素自费支出上限和雇主赞助的保险:胰岛素和医疗保健的自费和总成本的变化
Khrysta A Baig1, Carrie E Fry1,2, Melinda B Buntin1,2,3
1Department of Health Policy, Vanderbilt University, Nashville, Tennessee, USA.
Health services research
|June 17, 2025
概括
国家自付胰岛素上限适度降低了完全保险用户的成本,特别是高支出者,而整体医疗保健成本没有增加. 政策影响可能会随着时间的推移而增长.
科学领域:
- 卫生经济学 卫生经济学
- 制药政策 制药政策
- 医疗服务研究 医疗服务研究
背景情况:
- 胰岛素成本的上升影响了雇主赞助的保险患者.
- 国家层面的政策旨在减轻胰岛素自付费用.
- 了解这些上限的经济影响对于政策评估至关重要.
研究的目的:
- 为了估计国家强制性胰岛素口袋外盖的影响.
- 分析胰岛素使用者的自费和总医疗费用的变化.
- 评估对完全保险和自筹资金的雇主计划的影响.
主要方法:
- 准实验性的三重差异差异 (DDD) 设计.
- 对胰岛素使用者的多载体索赔数据的分析. 在上市前和后实施.
- 具有和没有胰岛素成本上限的状态之间的比较.
主要成果:
- 观察到30天和每年胰岛素自费支出的适度下降 (DDD:每年-67美元).
- 在高消费者中发现了更大的储蓄 (第95个百分点:每年-347美元).
- 没有发现总体年度医疗保健成本的统计学上显著增加.
结论:
- 早期状态的胰岛素盖在完全保险用户的自付费用方面显示出适度的好处.
- 对于支出最高的个人来说,储蓄更为明显.
- 没有证据表明上限增加了医疗保健总支出;影响可能随着时间的推移而演变.
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