The Center for Medical Technology Assessment, CMT Linköping University, 581 83 Linköping, Sweden.
Health Policy. 2012 Dec;108(2-3):207-15. doi: 10.1016/j.healthpol.2012.10.008. Epub 2012 Nov 8.
A new reimbursement scheme (RS) for glucose lowering therapies (GLT) was implemented in Sweden on March 1, 2010. Products on the market were retained, restricted, excluded or excluded for new courses in the new RS. The aim of this study was to compare utilization and costs of GLT for type 2 diabetes Mellitus (T2DM) before and after the implementation of the changed RS.
This was a quasi-experimental study using data on dispensed GLT and costs from a database on dispensed individual based prescriptions in Sweden. Segmented regression analyses were used to assess utilization and costs.
Following the changed reimbursement status, there was an accelerated increasing trend in number of patients treated with restricted (P=0.0007) or retained (P=0.0021) insulins, as well as in costs for insulin based GLT (P=0.0014). No impact was detected in the total number of patients treated with oral GLT, but a slightly negative trend in total costs for oral GLT was detected following the intervention (P=0.0177).
The new reimbursement scheme had a minor impact on utilization and costs of oral GLT. Despite restricted reimbursement for patients with T2DM, the utilization of insulin based GLT and related costs increased faster following the intervention.
2010 年 3 月 1 日，瑞典实施了一种新的降糖治疗（GLT）报销方案（RS）。市场上的产品在新 RS 中被保留、限制、排除或排除用于新疗程。本研究旨在比较 RS 变更前后 2 型糖尿病（T2DM）GLT 的使用情况和成本。
这是一项使用瑞典个人处方配药数据库中配药 GLT 和成本数据的准实验研究。采用分段回归分析评估使用情况和成本。
改变报销状况后，接受限制（P=0.0007）或保留（P=0.0021）胰岛素治疗的患者数量以及胰岛素 GLT 治疗的成本呈加速增长趋势（P=0.0014）。接受口服 GLT 治疗的患者总数没有影响，但干预后口服 GLT 的总成本呈略微负向趋势（P=0.0177）。
新的报销方案对口服 GLT 的使用情况和成本影响较小。尽管对 T2DM 患者的胰岛素报销受到限制，但干预后，基于胰岛素的 GLT 的使用和相关成本增长更快。
