Harvard Medical School, USA.
Health Aff (Millwood). 2010 Nov;29(11):1995-2001. doi: 10.1377/hlthaff.2010.0336.
To date, there has been little empirical evidence to support the broader use of value-based insurance design, which lowers copayments for services with high value relative to their costs. To address this lack of data, we evaluated the impact of the value-based insurance program of a US corporation, Pitney Bowes. The program eliminated copayments for cholesterol-lowering statins and reduced them for clopidogrel, a blood clot inhibitor. We found that the policy was associated with an immediate 2.8 percent increase in adherence to statins relative to controls, which was maintained for the subsequent year. For clopidogrel, the policy was associated with an immediate stabilizing of the adherence rate and a four-percentage-point difference between intervention and control subjects a year later. Our study thus provides an empirical basis for the use of this approach to improve the quality of health care.
迄今为止，几乎没有经验证据支持更广泛地采用基于价值的保险设计，这种设计降低了相对于成本而言具有高价值的服务的共付额。为了解决这一数据的缺乏，我们评估了美国公司 Pitney Bowes 的基于价值的保险计划的影响。该计划取消了降低胆固醇的他汀类药物的共付额，并降低了抗血小板药物氯吡格雷的共付额。我们发现，与对照组相比，该政策立即使他汀类药物的遵医嘱率提高了 2.8%，并在随后的一年中保持了这一水平。对于氯吡格雷，该政策立即稳定了遵医嘱率，一年后干预组和对照组之间的差异为 4 个百分点。因此，我们的研究为使用这种方法来提高医疗保健质量提供了经验依据。
