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心肌梗死后患者是否应免费接受二级预防药物治疗?一项经济学分析。

Should patients receive secondary prevention medications for free after a myocardial infarction? An economic analysis.

作者信息

Choudhry Niteesh K, Avorn Jerry, Antman Elliott M, Schneeweiss Sebastian, Shrank William H

机构信息

Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts, USA.

出版信息

Health Aff (Millwood). 2007 Jan-Feb;26(1):186-94. doi: 10.1377/hlthaff.26.1.186.

Abstract

Taken in combination, aspirin, beta-blockers, angiotensin-converting enzyme (ACE) inhibitors, and statins (combination pharmacotherapy) greatly reduce cardiac events. These therapies are underused, even among patients with drug insurance. Out-of-pocket spending is a key barrier to adherence. We estimated the impact of providing combination pharmacotherapy without cost sharing ("full coverage") to insured patients after a myocardial infarction (MI). Under base-case assumptions, compared to standard coverage, three years of full coverage will reduce mortality and reinfarction rates and will save 5,974 per patient. Our analysis suggests that covering combination therapy for such patients will save both lives and money.

摘要

联合使用阿司匹林、β受体阻滞剂、血管紧张素转换酶(ACE)抑制剂和他汀类药物(联合药物治疗)可大大降低心脏事件的发生。这些疗法的使用不足,即使在有药物保险的患者中也是如此。自付费用是坚持治疗的关键障碍。我们估计了为心肌梗死(MI)后的参保患者提供无费用分担的联合药物治疗(“全额覆盖”)的影响。在基本假设情况下,与标准保险相比,三年的全额覆盖将降低死亡率和再梗死率,每位患者可节省5974美元。我们的分析表明,为这类患者提供联合治疗可挽救生命并节省费用。

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