Delate Thomas, Wang Steven
PhD, MS. Clinical Pharmacy Research Scientist. Pharmacy Department, Kaiser Permanente Colorado. Aurora, CO (United States).
BS. Pharmacy Intern, Pharmacy Department, Kaiser Permanente Colorado. Aurora, CO (United States).
Pharm Pract (Granada). 2017 Apr-Jun;15(2):940. doi: 10.18549/PharmPract.2017.02.940. Epub 2017 Jun 30.
The purpose of this study was to describe the rate of medication short-term supply dispensings (tider), patient and medication characteristics associated with a tider, and costs for tider dispensings in an integrated healthcare delivery system in Colorado, United States.
This was a retrospective study conducted in an integrated healthcare delivery system's outpatient clinics. All patients who had a prescription dispensed for a study medication at any of the system's 28 outpatient pharmacies during the first quarter of 2016 were included. A tider was identified as a 3-day supply of a prescription medication that was dispensed at no charge to a patient. The quarterly tider rate and the per member per month (PMPM) cost of tiders were estimated. Patient and medication characteristics associated with a tider were assessed.
A total of 444,225 study medications were dispensed for 135,907 patients during the study period. There were 3,430 (0.77%, 95%CI 0.75%:0.80%) medications dispensed as a tider. The PMPM cost of tider medications and their dispensing fees was USD 0.03. There were 1,092 (0.8%) and 134,815 (99.2%) patients who did and did not, respectively, have at least one tider dispensed during the study period. Patient characteristics strongly associated with having had a tider dispensed included being older, male, and a Medicare beneficiary. Cardiovascular and neuromuscular medications had the highest rates of tider dispensing.
The rate of tider dispensing was relatively low; however, approximately one out of 125 patients had at least one tider. Patients who had a tider were more likely to be older, female, a Medicare beneficiary, and having had a previous tider dispensing and a higher burden of chronic disease. The tider medication was more likely to be a cardiovascular or neuromuscular medication class and more likely to be dispensed on a weekend. The total cost of dispensing a tider appears reasonable since the benefits of providing patients with needed medications likely outweigh the cost. Future studies should be performed to assess the impact of tider dispensing on health outcomes.
本研究旨在描述美国科罗拉多州一个综合医疗服务体系中药物短期供应配药（潮汐配药）的比例、与潮汐配药相关的患者和药物特征，以及潮汐配药的成本。
这是一项在综合医疗服务体系的门诊诊所进行的回顾性研究。纳入了2016年第一季度在该体系的28家门诊药房中任何一家配取研究药物处方的所有患者。潮汐配药被定义为免费配发给患者的3天用量的处方药。估算了季度潮汐配药比例以及每位成员每月（PMPM）的潮汐配药成本。评估了与潮汐配药相关的患者和药物特征。
在研究期间，共为135,907名患者配取了444,225份研究药物。有3430份（0.77%，95%置信区间0.75%:0.80%）药物作为潮汐配药进行了分发。潮汐配药药物及其配药费用的PMPM成本为0.03美元。在研究期间，分别有1092名（0.8%）和134,815名（99.2%）患者至少有一次和没有一次潮汐配药。与接受潮汐配药密切相关的患者特征包括年龄较大、男性以及是医疗保险受益人。心血管和神经肌肉药物的潮汐配药比例最高。
潮汐配药比例相对较低；然而，约每125名患者中就有1人至少有一次潮汐配药。接受潮汐配药的患者更可能年龄较大、为女性、是医疗保险受益人，并且之前有过潮汐配药且慢性病负担较重。潮汐配药药物更可能是心血管或神经肌肉药物类别，并且更可能在周末分发。由于为患者提供所需药物的益处可能超过成本，因此潮汐配药的总成本似乎是合理的。未来应开展研究以评估潮汐配药对健康结局的影响。
