Department of Pharmaceutical Systems and Policy, West Virginia University, PO Box 9510, Robert C. Byrd Health Sciences Center, Morgantown, WV 26506, USA.
Soc Work Public Health. 2012;27(6):537-53. doi: 10.1080/19371910903183086.
Rising prescription drug expenditure is a growing concern for publicly funded drug benefit programs like Medicaid. To be able to contain drug expenditures in Medicaid, it is important that cause(s) for such increases are identified. This study attempts to establish an explanatory model for Medicaid prescription drugs expenditure based on the impacts of key influencers/predictors identified using a comprehensive framework of drug utilization. A modified Andersen's behavior model of health services utilization is employed to identify potential determinants of pharmaceutical expenditures in state Medicaid programs. Level of federal matching funds, access to primary care, severity of diseases, unemployment, and education levels were found to be key influencers of Medicaid prescription drug expenditure. Increases in all, except education levels, were found to result in increases in drug expenditures. Findings from this study could better inform intervention policies and cost-containment strategies for state Medicaid drug benefit programs.
处方药支出的不断增加，是像医疗补助（Medicaid）这样的公共资助药品福利项目日益关注的问题。为了能够控制医疗补助计划中的药品支出，确定导致支出增加的原因非常重要。本研究试图根据使用药物利用综合框架确定的关键影响因素/预测因素，建立一个基于医疗补助处方药支出的解释模型。采用改良的安德森卫生服务利用行为模型，确定州医疗补助计划中药物支出的潜在决定因素。研究发现，联邦配套资金水平、获得初级保健的机会、疾病严重程度、失业和教育水平是医疗补助处方药支出的关键影响因素。除了教育水平之外，所有这些因素的增加都导致了药品支出的增加。本研究的结果可以为州医疗补助药品福利计划的干预政策和成本控制策略提供更好的信息。
