Thomson Reuters, Ann Arbor, Michigan, USA.
Health Aff (Millwood). 2011 Jan;30(1):109-17. doi: 10.1377/hlthaff.2010.0510.
This paper contributes to a small but growing body of evidence regarding the efficacy of value-based insurance design. In a retrospective, observational study of employees of a large global pharmaceutical firm, we evaluated how reduced patient cost sharing for prescription drugs for asthma, hypertension, and diabetes affected the use of these drugs and related medical services. We estimate that prescription medication use rose 5 percent per enrollee across the entire enrolled population. Increased use was most evident for patients taking cardiovascular medication. By the third year, adherence to cardiovascular medications was 9.4 percent higher, and patients realized cost savings over time. Overall, the program was mostly cost-neutral to the company, and there was no aggregate change in spending. However, we raise the prospect that this program may have saved the company money by reducing other medical costs.
本文为价值为基础的保险设计的功效提供了一个虽小但不断增长的证据基础。通过对一家大型全球制药公司员工的回顾性观察性研究，我们评估了降低哮喘、高血压和糖尿病处方药的患者自付费用对这些药物和相关医疗服务的使用的影响。我们估计，整个参保人群中，每位参保者的处方药使用量增加了 5%。心血管药物的使用增加最为明显。到第三年，心血管药物的依从性提高了 9.4%，患者的成本随着时间的推移而节省。总体而言，该计划对公司来说基本没有成本，也没有总体支出的变化。然而，我们提出这样一种可能性，即该计划可能通过降低其他医疗成本为公司节省了资金。
