Chisholm Marie A, Marshall Josh, Smith Kimberly E, Garrett Charlene J, Turner Jeanie C
University of Georgia College of Pharmacy, Augusta, GA 30912, USA.
Clin Transplant. 2005 Jun;19(3):357-63. doi: 10.1111/j.1399-0012.2005.00349.x.
Post-transplant prescription medications are expensive, often costing over 12,000 dollars annually. Many solid-organ transplant patients have Medicare coverage and patients enrolled in Medicare-approved drug discount card (MADDC) programs may be able to receive prescription medications at a reduced price. However, many transplant healthcare practitioners are unaware of the utility of MADDCs. The purpose of this study was to determine whether enrolling renal transplant patients (RTPs) into a MADDC produces significant savings in prescription costs.
Two Medicare RTPs, with prescription medication profiles representative of an RTP within 3 months post-transplant and an RTP greater than 5 yr post-transplant, were randomly selected from the Medication Access Program's database. Cost benefit analyses were from the patients' perspective and were performed using the: (i) prescription cost from the Medicare website of MADDCs that listed the greatest and least prescription costs compared with the retail cash price of the same prescription without using the MADDCs; and (ii) MADDCs' annual enrollment fee. The potential cost difference of using MADDCs and not using MADDCs to purchase the prescription medications were calculated.
RTPs' monthly out-of-pocket cost for prescription medications ranged from 162 dollars to 340 dollars, and MADDCs offered discounts of 20-37% from retail prices; thus outweighing the MADDC enrollment cost.
MADDCs, when selected and used appropriately, can reduce prescription medication cost for RTPs. Card selection is of great importance as discount rates vary greatly among cards, and only under restricted circumstances is a patient allowed to switch to another card. It is imperative that practitioners are aware of these programs and utilize cost-effective prescribing practices.
移植后处方药费用高昂，每年通常超过12000美元。许多实体器官移植患者享有医疗保险，参加医疗保险批准的药品折扣卡（MADDC）计划的患者或许能够以较低价格获得处方药。然而，许多移植医疗从业者并不了解MADDC的作用。本研究的目的是确定让肾移植患者（RTP）加入MADDC是否能显著节省处方药费用。
从药物获取计划的数据库中随机选取两名医疗保险RTP，其用药情况分别代表移植后3个月内的RTP和移植后超过5年的RTP。成本效益分析从患者角度进行，使用：（i）MADDC医疗保险网站上列出的最高和最低处方药成本与不使用MADDC时相同处方的零售现金价格相比；以及（ii）MADDC的年度注册费。计算使用MADDC和不使用MADDC购买处方药的潜在成本差异。
RTP每月处方药自付费用在162美元至3,美元之间，MADDC提供的折扣比零售价低20 - 37%；因此超过了MADDC的注册成本。
MADDC在适当选择和使用时，可以降低RTP的处方药成本。卡的选择非常重要，因为不同卡的折扣率差异很大，且患者仅在有限情况下才允许更换为另一张卡。从业者必须了解这些计划并采用具有成本效益的处方做法。
