抗血管内皮生长因子的经济影响从一个大型电子数据库的先前授权过程
Ella H Leung1, Saira Khanna2, Michael M Lai3
1Georgia Retina, Atlanta, GA, USA.
Journal of vitreoretinal diseases
|November 17, 2025
概括
针对抗血管内皮生长因子 (抗VEGF) 疗法的事先授权 (PA) 增加了社会成本,尽管批准率高. 该PA过程并没有节省成本,为患者,提供者和工作场所增加了大量费用.
科学领域:
- 卫生经济学 卫生经济学
- 眼科医生 眼科 眼科
- 卫生政策 卫生政策
背景情况:
- 预先授权 (PA) 是获得治疗的行政障碍.
- 抗血管内皮生长因子 (抗VEGF) 疗法对于治疗视网膜疾病至关重要.
研究的目的:
- 量化对抗VEGF疗法的保险事先授权 (PAs) 对社会经济影响.
- 分析PA工艺对抗VEGF治疗的成本效益.
主要方法:
- 从大型电子数据库 (SamaCare PA) 中分析了PA拒绝和延迟率.
- 利用理论性成本效益模型来计算与PA相关的社会成本增加.
- 估计在2025年的成本是美元.
主要成果:
- 预先授权 (PAs) 增加了每位患者一生的总社会成本10,842.24美元.
- 在PA过程中,每次请求增加了637.78美元,从拒绝中节省了很少的钱 (每次注射27.11美元).
- 在超过99.9%的场景中,PAs没有节省成本,增加了工作场所,患者和提供者的成本,而保险公司的收益很小.
结论:
- 对抗VEGF疗法的事先授权请求在97.7%的案例中得到批准,但在97.9%的案例中被推迟.
- 该PA过程并没有节省成本,并且显著提高了抗VEGF治疗的总社会成本.
- 保险公司是唯一一个可能从PA过程中获得财务利益的实体.
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