医疗保险部分 D 对高血压药物治疗的影响。
The impact of Medicare Part D on medication treatment of hypertension.
机构信息
Department of Health Policy and Management, University of Pittsburgh, 130 De Soto Street, Crabtree Hall A664, Pittsburgh, PA 15261, USA.
出版信息
Health Serv Res. 2011 Feb;46(1 Pt 1):185-98. doi: 10.1111/j.1475-6773.2010.01183.x. Epub 2010 Sep 28.
OBJECTIVE
To evaluate Medicare Part D's impact on use of antihypertensive medications among seniors with hypertension.
DATA SOURCES
Medicare-Advantage plan pharmacy data from January 1, 2004 to December 12, 2007 from three groups who before enrolling in Part D had no or limited drug benefits, and a comparison group with stable employer-based coverage.
STUDY DESIGN
Pre-post intervention with a comparison group design was used to study likelihood of use, daily counts, and substitutions between angiotensin-converting enzyme inhibitors and angiotensin-II receptor blockers (ARBs).
PRINCIPAL FINDINGS
Antihypertensive use increased most among those without prior drug coverage: likelihood of use increased (odds ratio = 1.40, 95 percent confidence interval [CI] 1.25-1.56), and daily counts increased 0.29 (95 percent CI 0.24-0.33). Proportion using ARBs increased from 40 to 46 percent.
CONCLUSIONS
Part D was associated with increased antihypertensive use and use of ARBs over less expensive alternatives.
目的
评估医疗保险处方药部分（Medicare Part D）对高血压老年患者使用抗高血压药物的影响。
数据来源
2004 年 1 月 1 日至 2007 年 12 月 12 日，来自三组老年人的医疗保险优势计划药房数据，这三组老年人在参加处方药部分之前没有或只有有限的药物福利，以及一组具有稳定雇主为基础的覆盖范围的比较组。
研究设计
使用前后干预与比较组设计来研究使用的可能性、每日用量和血管紧张素转换酶抑制剂和血管紧张素 II 受体阻滞剂（ARBs）之间的替代情况。
主要发现
在没有先前药物覆盖的人群中，抗高血压药物的使用增加最多：使用的可能性增加（优势比=1.40，95%置信区间[CI]为 1.25-1.56），每日用量增加 0.29（95%CI 为 0.24-0.33）。使用 ARBs 的比例从 40%增加到 46%。
结论
处方药部分与增加抗高血压药物的使用和使用更便宜的替代药物的 ARBs 有关。
Zotero 插件