节省生物类似药和Medicare表单访问的成本
Kirsten Axelsen1, Delphine Courmier2, Ge Bai3
1DLA Piper, Policy Advisor, New York, NY, 10020, United States.
Health affairs scholar
|November 28, 2025
概括
医疗保险D部分表单设计限制了生物类似的访问和成本节省. 与仿制药相比,阿达利穆马布生物仿制药的配方位较低,患者成本较高,阻碍了投资和市场增长.
科学领域:
- 卫生经济学 卫生经济学
- 制药政策 制药政策
- 生物制品和生物类似药物
背景情况:
- 医疗保险D部分表单设计影响患者获得药物的机会.
- 生物仿制药提供了潜在的成本节约,但面临着市场准入挑战.
- 治疗炎症的生物药物阿达利穆马布 (Adalimumab) 有多种批准的生物类似药,包括可互换的生物类似药.
研究的目的:
- 评估医疗保险D部分表单设计如何影响生物相似接入和成本节省.
- 评估表单设计对投资生物类似开发的影响.
- 将阿达利穆马布生物类似药作为D部分配方药实践的案例研究.
主要方法:
- 对阿达利穆马布生物类似药的医疗保险D部分表单数据的分析.
- 生物类似药与创新产品的配方药准入和患者成本共享的比较.
- 对美国生物仿制药市场的市场趋势和投资因素的审查.
主要成果:
- 与创新产品相比,Adalimumab生物类似药在医疗保险D部分的配方准入率较低.
- 当可用时,阿达利穆马布生物仿制药通常需要共同保险,导致患者的费用高于仿制药常见的固定合并费.
- 美国生物类似药市场的增长缓慢,限制了潜在的成本节约和投资回报.
结论:
- 目前的医疗保险 (Medicare) D部分表单设计造成了生物类似药物获取和成本节约的障碍.
- 对生物仿制药的患者成本共享结构阻碍了吸收和投资.
- 政策变化鼓励更广泛地将生物类似药物纳入医疗保险可以刺激发展和市场增长.
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