神经学药物事先授权的障碍和后果:一个范围审查
Evelyn Gotlieb1,2, Bamby Joseph3, Leah Blank4,5
1Icahn School of Medicine at Mount Sinai, New York, New York.
JAMA neurology
|December 8, 2025
概括
预先授权 (PA) 对神经病患者造成了严重的药物获取障碍,导致延迟和疾病进展. 需要进行改革,以确保平等地获得阿尔茨海默病和等疾病的基本治疗方法.
科学领域:
- 神经学 神经学
- 医疗保健服务研究 医疗服务研究
- 药物经济学 药物经济学
背景情况:
- 预先授权 (PA) 是保险公司用来管理医疗保健成本和促进基于价值的护理的一种工具.
- 然而,PA可能会阻碍患者获得必要的药物,特别是在神经病学中,及时治疗至关重要.
- 这对阿尔茨海默病,帕金森病,多发性硬化症,偏头痛,脑血管疾病和等疾病越来越关注.
研究的目的:
- 评估事先授权政策的后果,障碍和促进者.
- 了解这些政策对六种常见神经疾病的药物治疗机会的影响.
- 评估对患者,临床医生和管理人员的影响.
主要方法:
- 根据PRISMA指南进行了范围审查.
- 在MEDLINE和Embase数据库中进行了搜索,截至2024年11月1日.
- 包括2010年3月之后发表的20项研究,并进行了主题分析.
主要成果:
- 患者经历了显著的护理延迟 (60%) 和增加的疾病活动 (25%).
- 临床医生 (35%) 和管理人员 (15%) 报告了大量的时间负担.
- 促进者包括临床药剂师/技术人员 (20%) 和卫生系统专业药房 (15%) 的参与.
结论:
- 预先授权对患有神经疾病的个人构成了相当大的访问障碍.
- 公共卫生政策给患者,临床医生和管理人员带来负担.
- 政策改革是必要的,以改善神经病患者平等获得药物的机会.
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