药房利用与《医疗保险现代化法案》。
Pharmacy utilization and the Medicare Modernization Act.
作者信息
Maio Vittorio, Pizzi Laura, Roumm Adam R, Clarke Janice, Goldfarb Neil I, Nash David B, Chess David
机构信息
Department of Health Policy, Jefferson Medical College, Philadelphia, PA 19107, USA.
出版信息
Milbank Q. 2005;83(1):101-30. doi: 10.1111/j.0887-378X.2005.00337.x.
Abstract
To control expenditures and use medications appropriately, the Medicare drug coverage program has established pharmacy utilization management (PUM) measures. This article assesses the effects of these strategies on the care of seniors. The literature suggests that although caps on drug benefits lower pharmaceutical costs, they may also increase the use of other health care services and hurt health outcomes. Our review raises concerns regarding the potential unintended effects of the Medicare drug program's PUM policies for beneficiaries. Therefore, the economic and clinical impact of PUM measures on seniors should be studied further to help policymakers design better drug benefit plans.
摘要
为了控制支出并合理用药，医疗保险药品覆盖计划制定了药房利用管理（PUM）措施。本文评估了这些策略对老年人护理的影响。文献表明，尽管药品福利上限降低了药品成本，但它们也可能增加其他医疗服务的使用，并损害健康结果。我们的综述引发了对医疗保险药品计划的PUM政策对受益人的潜在意外影响的担忧。因此，应进一步研究PUM措施对老年人的经济和临床影响，以帮助政策制定者设计更好的药品福利计划。
相似文献
1
Pharmacy utilization and the Medicare Modernization Act.
Milbank Q. 2005;83(1):101-30. doi: 10.1111/j.0887-378X.2005.00337.x.
2
Drug insurance utilization management policies and "reference pricing": an illustrated commentary on the article by Vittorio Maio and colleagues.
Milbank Q. 2005;83(1):131-47. doi: 10.1111/j.0887-378X.2005.00338.x.
3
Medicare program; Medicare prescription drug benefit. Final rule.
Fed Regist. 2005 Jan 28;70(18):4193-585.
4
Medicare program; establishment of the Medicare advantage program. Final rule.
Fed Regist. 2005 Jan 28;70(18):4587-741.
5
How beneficiaries fare under the new Medicare drug bill.
Issue Brief (Commonw Fund). 2004 Jun(730):1-16.
6
Pharmaceuticals: Medicare Modernization Act--2005. End of Year Issue Brief.
Issue Brief Health Policy Track Serv. 2005 Dec 31:1-21.
7
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003.
J Am Geriatr Soc. 2004 Jun;52(6):1013-5. doi: 10.1111/j.1532-5415.2004.52295.x.
8
Medicare prescription drug legislation: how would it affect beneficiaries?
Policy Brief Commonw Fund. 2003 Oct(678):1-12.
9
Medicare program; Medicare prescription drug discount card. Interim final rule with comment period.
Fed Regist. 2003 Dec 15;68(240):69839-927.
10
Medicare Part D--the product of a broken process.
N Engl J Med. 2006 Jun 1;354(22):2314-5. doi: 10.1056/NEJMp068116.
引用本文的文献
1
Explaining why increases in generic use outpace decreases in brand name medicine use in multisource markets and the role of regulation.
PLoS One. 2024 May 2;19(5):e0301716. doi: 10.1371/journal.pone.0301716. eCollection 2024.
2
Respiratory questionnaire-based analysis of awareness of COPD in a large multicenter rural population-based study in India.
Chronic Dis Transl Med. 2022 Sep 17;8(4):322-330. doi: 10.1002/cdt3.47. eCollection 2022 Dec.
3
A systematic umbrella review of the association of prescription drug insurance and cost-sharing with drug use, health services use, and health.
BMC Health Serv Res. 2022 Mar 3;22(1):297. doi: 10.1186/s12913-022-07554-w.
4
Interventions to improve safe and effective medicines use by consumers: an overview of systematic reviews.
Cochrane Database Syst Rev. 2014 Apr 29;2014(4):CD007768. doi: 10.1002/14651858.CD007768.pub3.
5
Whom do older adults trust most to provide information about prescription drugs?
Am J Geriatr Pharmacother. 2009 Apr;7(2):105-16. doi: 10.1016/j.amjopharm.2009.04.005.
6
Medication adherence issues in patients treated for COPD.
Int J Chron Obstruct Pulmon Dis. 2008;3(3):371-84. doi: 10.2147/copd.s3036.
7
Coverage of atypical antipsychotics among medicare drug plans in the state of washington for fiscal year 2007.
Prim Care Companion J Clin Psychiatry. 2008;10(4):313-7. doi: 10.4088/pcc.v10n0407.
8
Potential savings from an evidence-based consumer-oriented public education campaign on prescription drugs.
Health Serv Res. 2008 Oct;43(5 Pt 1):1557-75. doi: 10.1111/j.1475-6773.2008.00858.x. Epub 2008 May 13.
9
What impact do prescription drug charges have on efficiency and equity? Evidence from high-income countries.
Int J Equity Health. 2008 May 2;7:12. doi: 10.1186/1475-9276-7-12.
10
Public/private partnerships for prescription drug coverage: policy formulation and outcomes in Quebec's universal drug insurance program, with comparisons to the Medicare prescription drug program in the United States.
Milbank Q. 2007 Sep;85(3):469-98. doi: 10.1111/j.1468-0009.2007.00496.x.
本文引用的文献
1
A political history of medicare and prescription drug coverage.
Milbank Q. 2004;82(2):283-354. doi: 10.1111/j.0887-378X.2004.00311.x.
2
How beneficiaries fare under the new Medicare drug bill.
Issue Brief (Commonw Fund). 2004 Jun(730):1-16.
3
Effects of prescription drug user fees on drug and health services use and on health status in vulnerable populations: a systematic review of the evidence.
Int J Health Serv. 2004;34(1):101-22. doi: 10.2190/4M3E-L0YF-W1TD-EKG0.
4
The effect of incentive-based formularies on prescription-drug utilization and spending.
N Engl J Med. 2003 Dec 4;349(23):2224-32. doi: 10.1056/NEJMsa030954.
5
Effects of a 3-tier pharmacy benefit design on the prescription purchasing behavior of individuals with chronic disease.
J Manag Care Pharm. 2003 Mar-Apr;9(2):123-33. doi: 10.18553/jmcp.2003.9.2.123.
6
Financial disparities in prescription drug use between elderly and nonelderly Americans.
Health Aff (Millwood). 2003 Sep-Oct;22(5):210-21. doi: 10.1377/hlthaff.22.5.210.
7
Impact of an annual dollar limit or "cap" on prescription drug benefits for Medicare patients.
JAMA. 2003 Jul 9;290(2):222-7. doi: 10.1001/jama.290.2.222.
8
Impact of health plan design and management on retirees' prescription drug use and spending, 2001.
Health Aff (Millwood). 2002 Jul-Dec;Suppl Web Exclusives:W408-19. doi: 10.1377/hlthaff.w2.408.
9
Approaches to pharmacy benefit management and the impact of consumer cost sharing.
Clin Ther. 2003 Jan;25(1):250-72. doi: 10.1016/s0149-2918(03)90035-x.
10
Evaluation of the clinical and economic impact of a brand name-to-generic warfarin sodium conversion program.
Pharmacotherapy. 2003 Mar;23(3):360-8. doi: 10.1592/phco.23.3.360.32103.
Zotero 插件