Roberto Pamela N, Brandt Nicole, Onukwugha Eberechukwu, Perfetto Eleanor, Powers Christopher, Stuart Bruce
Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, 220 Arch Street, 12th Floor, Baltimore, MD, 21201, USA.
Pharmaceutical Research and Manufacturers of America, 950 F Street, NW, Washington, DC, 20004, USA.
Adm Policy Ment Health. 2017 Nov;44(6):943-954. doi: 10.1007/s10488-017-0813-2.
Prior research demonstrates substantial access problems associated with utilization management and formulary exclusions for antipsychotics in Medicaid, but the use and impact of coverage restrictions for these medications in Medicare Part D remains unknown. We assess the effect of coverage restrictions on antipsychotic utilization in Part D by exploiting a unique natural experiment in which low-income beneficiaries are randomly assigned to prescription drug plans with varying levels of formulary generosity. Despite considerable variation in use of coverage restrictions across Part D plans, we find no evidence that these restrictions significantly deter utilization or reduce access to antipsychotics for low-income beneficiaries.
先前的研究表明，医疗补助计划中与抗精神病药物的使用管理和处方集排除相关的获取问题严重，但医疗保险D部分中这些药物的覆盖范围限制的使用和影响仍不明确。我们通过利用一项独特的自然实验来评估D部分中覆盖范围限制对抗精神病药物使用的影响，在该实验中，低收入受益人被随机分配到具有不同处方集慷慨程度的处方药计划中。尽管D部分各计划在覆盖范围限制的使用上存在很大差异，但我们没有发现证据表明这些限制会显著阻碍低收入受益人的药物使用或减少他们获得抗精神病药物的机会。
