Castellon Yelba M, Bazargan-Hejazi Shahrzad, Masatsugu Miles, Contreras Roberto
Charles R. Drew University of Medicine and Science, 1731 E 120th St, Los Angeles, CA 90059. E-mail:
Am J Manag Care. 2014 Feb;20(2):146-50.
Patient assistance programs and the 340B Drug Pricing Program promise to improve the financial stability, better serve vulnerable patients, and decrease the burden of cost for uninsured patients. Our objective is to examine the financial impact that PAPs and the 340B Program have on improving medication cost.
Retrospective analysis of medication dispensary data.
Dispensary data for uninsured patients obtaining medications at 2 community health centers were collected from February 1 to February 29, 2012. Uninsured patients were divided into 2 samples: (1) patients receiving PAP medications and (2) patients receiving 340B medications. The main outcome measured was the patient's cost savings. Cost savings were calculated based on the amount a medication would have cost had it been purchased by patients at prices found on Epocrates software (drugstore.com). A paired sample t test model using continuous variables was utilized to calculate confidence intervals.
A total of 1420 PAP and 2772 340B individual medications were dispensed to uninsured patients in February 2012. For patients receiving PAP medications the mean ± standard deviation (SD) for age = 52 ± 10. Average cost was $0.11 (95% CI, $0.04-$0.17) and average savings was $617.36 (95% Cl, $581.32-$653.40). For patients receiving 340B medications the mean ±SD for age = 50 ± 14. Average cost was $11.50 (95% CI, $10.55-$12.45). Average saving was $62.31 (95% CI, $57.99-$66.63).
PAPs and 340B provide significant medication savings for uninsured patient. More research is needed to establish "best practices" for the successful integration of PAPs.
患者援助计划和340B药品定价计划有望改善财务稳定性，更好地服务弱势患者，并减轻未参保患者的费用负担。我们的目标是研究患者援助计划和340B计划对降低药物成本的财务影响。
对药房配药数据进行回顾性分析。
收集2012年2月1日至2月29日期间在2家社区卫生中心获取药物的未参保患者的药房数据。未参保患者被分为2组：（1）接受患者援助计划药物的患者；（2）接受340B计划药物的患者。主要测量结果是患者节省的费用。节省的费用是根据患者使用Epocrates软件（drugstore.com）上的价格购买药物时的花费来计算的。使用连续变量的配对样本t检验模型来计算置信区间。
2012年2月，共向未参保患者发放了1420份患者援助计划药物和2772份340B计划药物。接受患者援助计划药物的患者，年龄的均值±标准差（SD）为52±10。平均费用为0.11美元（95%置信区间，0.04 - 0.17美元），平均节省617.36美元（95%置信区间，581.32 - 653.40美元）。接受340B计划药物的患者，年龄的均值±标准差为50±14。平均费用为11.50美元（95%置信区间，10.55 - 12.45美元）。平均节省62.31美元（95%置信区间，57.99 - 66.63美元）。
患者援助计划和340B计划为未参保患者节省了大量药物费用。需要更多研究来确立患者援助计划成功整合的“最佳实践”。
