Patel Rajul A, Lipton Helene Levens, Cutler Timothy W, Smith Amanda R, Tsunoda Shirley M, Stebbins Marilyn R
Department of Pharmacy Practice, University of the Pacific, Stockton, CA 95211, USA.
Am J Manag Care. 2009 Aug;15(8):545-53.
To minimize out-of-pocket prescription drug plan (PDP) expenditures by Medicare beneficiaries.
Cost-minimization analysis.
Trained student pharmacists from 6 California pharmacy schools provided expert guidance on Medicare Part D PDPs to beneficiaries through interventions at statewide outreach events. Demographic and insurance information for 2008 was collected via survey. Cost information for the beneficiary's current PDP for 2008 and for the least expensive PDP for 2008 was obtained using the Medicare Plan Finder tool (http://www.medicare.gov).
Data were collected from 250 beneficiaries at 22 outreach events. For the cost-minimization analysis, data were excluded from 72 beneficiaries who were not enrolled in a stand-alone PDP before the intervention and from another 23 beneficiaries for whom information regarding their current PDP or prescription drug profile was incomplete. Of the remaining 155 study participants, 39.4% were male, the mean (SD) age was 74.6 (8.7) years, and they were taking a mean (SD) of 5.3 (3.5) prescription drugs each month. In addition, 68 beneficiaries (43.9%) had limited or no English proficiency, and 85 beneficiaries (54.8%) were enrolled in both Medicare and Medicaid. In total, 89.7% of beneficiaries could have realized cost savings by switching to a different PDP. The median annual potential cost savings was $98 per beneficiary but this varied as a function of subsidy level.
Targeted community outreach services to Medicare Part D beneficiaries can help optimize patient selection of a PDP, thereby resulting in lower out-of-pocket expenditures.
尽量减少医疗保险受益人自付的处方药计划(PDP)费用。
成本最小化分析。
来自6所加利福尼亚药学院的经过培训的学生药剂师,通过在全州范围的外展活动中进行干预,为受益人提供有关医疗保险D部分PDP的专业指导。2008年的人口统计学和保险信息通过调查收集。使用医疗保险计划查找工具(http://www.medicare.gov)获取受益人2008年当前PDP以及2008年最便宜PDP的成本信息。
在22次外展活动中收集了250名受益人的数据。在成本最小化分析中,排除了72名在干预前未参加独立PDP的受益人以及另外23名当前PDP或处方药资料信息不完整的受益人的数据。在其余155名研究参与者中,39.4%为男性,平均(标准差)年龄为74.6(8.7)岁,他们每月平均服用5.3(3.5)种处方药。此外,68名受益人(43.9%)英语水平有限或不懂英语,85名受益人(54.8%)同时参加了医疗保险和医疗补助。总体而言,89.7%的受益人通过改用不同的PDP可以实现成本节约。每位受益人的年度潜在成本节约中位数为98美元,但这因补贴水平而异。
针对医疗保险D部分受益人的有针对性的社区外展服务,有助于优化患者对PDP的选择,从而降低自付费用。