Powe N R
Welch Center for Prevention, Epidemiology, and Clinical Research and the Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA.
Semin Nephrol. 2000 Nov;20(6):535-42.
Prescription drugs have improved the length and quality of life for many persons, particularly those with chronic disease. However, their contribution to total health care costs has been increasing, making it difficult for patients to afford necessary medications. Current Medicare policy, derived from statutory enactments by Congress, precludes payment for prescription medications with the exception a few medications for end-stage renal disease (ESRD) patients. A more comprehensive prescription drug benefit for Medicare has been proposed that might benefit ESRD patients. Design and implementation of a medication drug benefit involves several issues including what medications should be covered, under what circumstances, how cost should be shared, the payment structure, level of payment, and management of the benefit. This report describes the experience with Medicare coverage of prescription drugs for ESRD patients and explores issues in offering a general medication insurance benefit under Medicare.
处方药改善了许多人的寿命和生活质量，尤其是那些患有慢性病的人。然而，它们在总体医疗保健成本中所占的比例一直在增加，这使得患者难以负担必要的药物。目前源自国会立法的医疗保险政策，除了为终末期肾病（ESRD）患者提供的少数几种药物外，不包括处方药的费用。有人提议为医疗保险提供更全面的处方药福利，这可能会使ESRD患者受益。处方药福利的设计和实施涉及几个问题，包括应涵盖哪些药物、在何种情况下、成本应如何分担、支付结构、支付水平以及福利管理。本报告描述了医疗保险为ESRD患者提供处方药覆盖的经验，并探讨了在医疗保险下提供一般药物保险福利的相关问题。
