340B药品定价计划,医院价格和商业市场的竞争
Sunita M Desai1, Prianca Padmanabhan1, Kyle Smith1
1Department of Population Health, NYU School of Medicine, New York, USA.
Health services research
|February 1, 2026
概括
医院获得340B药品定价计划的资格,降低了临床医生在竞争性市场上管理的药品价格. 市场竞争是确保340B节省的关键,使付款人和患者受益.
科学领域:
- 卫生经济学 卫生经济学
- 制药政策 制药政策
- 市场分析市场分析.
背景情况:
- 340B药品定价计划旨在降低符合条件的医院的药品成本.
- 了解340B资格如何影响商业市场的药物价格至关重要.
- 市场竞争可能会影响储蓄的转移.
研究的目的:
- 确定340B药物定价计划的资格是否会降低商业保险中临床医生管理的药物的价格.
- 评估这些降价是否根据市场竞争而有所变化.
主要方法:
- 一项准实验性研究,使用基于340B资格门 (DSH百分比>11.75%) 的回归断续设计.
- 来自医疗保健成本研究所 (HCCI) 对非营利性和公共急症医院 (2012-2014) 的二次索赔数据的分析.
- 主要结果:高开支的门诊药物的谈判单位价格;次要结果:药品量和收入.
主要成果:
- 340B的资格与药物单位价格中位数降低605美元有关.
- 在竞争性市场 (HHI ≤1800),价格下降显著,下降793美元 (32%的下降).
- 在高度集中的市场中,影响很小且微不足道;价格下降被药品数量的不显著增加所抵消.
结论:
- 医院340B的资格有效地降低了商业药物价格,但仅在竞争性市场.
- 市场竞争在使政策驱动的成本节约能够与付款人和患者共享方面发挥着关键作用.
- 这些发现强调了市场动态对药品定价政策有效性的重要性.
相关概念视频
Hospitals-II
1.2K
Hospitals provide inpatient and outpatient services. Inpatient services provide care to patients that stay in the hospital for an extended period, ranging from days to months. Examples of inpatient services include intensive care units, hospital wards, or surgeries. Outpatient services provide care to patients who come to a hospital for a diagnostic or treatment but do not stay overnight —for example, diagnostic tests, surgical procedures, or health education.
Nurses that work in...
Nurses that work in...
1.2K
Competition
24.8K
When organisms require the same limited resources within an environment, they may have to compete for them. Competition is a net-negative interaction. Even if two competing individuals or populations do not interact directly, the overall fitness of both competitors is lowered as a result of not having full access to the limited resource.
24.8K
Hospitals-I
1.6K
Hospitals offer medical and surgical care to the sick and injured, along with accommodation while they recover. At the same time, they also provide outpatient, emergency, psychiatric, and rehabilitation services to meet various community needs. In addition to providing medical care, hospitals also act as hubs for medical research and training. Hospitals use clinical procedures and evidence-based practice standards to deliver patient care. To deliver safe and efficient care, a nurse must stay up...
1.6K
The Anchoring-and-Adjustment Heuristic
7.8K
In order to make good decisions, we use our knowledge and our reasoning. Often, this knowledge and reasoning is sound and solid. However, sometimes, we are swayed by biases or by others manipulating a situation. For example, let’s say you and three friends wanted to rent a house and had a combined target budget of $1,600. The realtor shows you only very run-down houses for $1,600 and then shows you a very nice house for $2,000. Might you ask each person to pay more in rent to get the...
7.8K
Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacokinetics
798
All neuromuscular blocking agents are injected intravenously because they are poorly absorbed from the GI tract. Rapid onset is achieved with intravenous administration, although absorption is also adequate from an intramuscular injection. Since these agents are highly ionized, they do not readily penetrate cell membranes or cross the blood-brain barrier.
Instead, they are transported by the blood to different tissues. Muscles with a greater blood supply (arteries) and blood flow receive more...
Instead, they are transported by the blood to different tissues. Muscles with a greater blood supply (arteries) and blood flow receive more...
798
Nondepolarizing (Competitive) Neuromuscular Blockers: Mechanism of Action
2.9K
Nondepolarizing neuromuscular blockers induce paralysis by competitively blocking nicotinic acetylcholine receptors at the muscle end plate. Examples include pancuronium, mivacurium, vecuronium, and rocuronium. These quaternary ammonium derivatives are administered intravenously, are poorly absorbed, and are excreted via the kidneys.
Competitive antagonists prevent acetylcholine from binding to its receptor, inhibiting membrane depolarization. Without conformational changes or intrinsic...
Competitive antagonists prevent acetylcholine from binding to its receptor, inhibiting membrane depolarization. Without conformational changes or intrinsic...
2.9K


