在被诊断为肌缩性侧面硬化症的第一年,医疗保险支出
Melissa Morley, Marisa Aurora, Kolton Gustafson1
1Avalere Health, 1201 New York Ave NW, Ste 1000, Washington, DC 20005.
The American journal of managed care
|October 27, 2025
概括
患有肌缩侧面硬化症 (ALS) 的医疗保险受益人承担的医疗保健费用要高得多,超过没有这种疾病的三倍. 药物治疗进一步增加了开支,突出了ALS患者和医疗保险的负担能力挑战.
科学领域:
- 卫生经济学 卫生经济学
- 神经学 神经学
- 公共卫生 公共卫生
背景情况:
- 肌缩侧面硬化症 (ALS) 是一种进展性神经退行性疾病,需要大量的医疗保健.
- 了解ALS对医疗保险受益者的财务负担对于政策制定至关重要.
研究的目的:
- 量化医疗保险支出和被诊断患有ALS的受益人的自付费用.
- 评估药物治疗对ALS患者护理总体成本的影响.
主要方法:
- 一项使用2017-2021年100%医疗保险服务费索赔的队列研究 (A,B和D部分).
- 2017-2020年期间通过ICD-10代码G12.21识别ALS受益人
- 在诊断后的12个月内评估医疗保健支出和受益人责任.
主要成果:
- 与没有ALS的人 (13,889美元) 相比,患有ALS的医疗保险受益人每年支出超过三倍 (47,450美元).
- 受益人自付负债表现出类似的趋势.
- 大约三分之一的ALS患者使用edaravone或riluzole,相关的护理费用更高.
结论:
- 对于患者和医疗保险计划来说,ALS对患者和医疗保险计划都造成了巨大的经济负担.
- 对ALS的疾病修饰药物有助于增加医疗保健成本.
- 目前的医疗保险政策可能无法充分解决与ALS治疗相关的负担能力挑战.
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