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三方:生物仿制药如何降低成本,扩大获取,提高利率

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概括

医疗保险患者在实施生物类药物优先战略后,参考生物使用量减少了47%. 这种转变降低了成本,增加了患者的获取,并改善了卫生系统的财务利率.

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科学领域:

  • 卫生经济学 卫生经济学
  • 制药政策 制药政策
  • 提高质量 提高科学 提高质量

背景情况:

  • 传统医疗保险服务费 (FFS) 涵盖没有事先授权 (PA) 的参考生物药物和生物类似药.
  • 生物类药物为参考生物制剂提供了经济,安全和有效的替代品.

研究的目的:

  • 将Medicare FFS患者在瘤学中使用参考生物药物的使用量减少50%.
  • 为了减少梅奥诊所社区负责护理组织 (MCC ACO) 的支出,并实现机构成本节省.
  • 通过增加生物类似药的利用来提高收入.

主要方法:

  • 实施了质量改进 (QI) 框架,以扩大生物类药物优先战略.
  • 利用有针对性的电子健康记录 (EHR) 报告来识别使用参考生物制剂的医疗保险患者,当生物类似药可用时.
  • 通过药剂师和医生推广和教育,促进患者转换为更低成本,更喜欢配方药的生物类药物.

主要成果:

  • 在医疗保险患者中减少了参考生物使用的47%.
  • 减少了MCC ACO支出262万美元,并减少了每个用户每月的支出13.9%.
  • 改善了超过220万美元的药物利率,每个药物类别的模型患者数量为1000人.

结论:

  • 质量改善举措有效地减少了医疗保险患者的参考生物使用量.
  • 转向生物仿制药成功降低了医疗保健支出,并增加了患者的获取.
  • 该战略改善了财务利,证明了采用生物类似药的经济效益.