Rebecca Myerson (
Tianyi Lu is a PhD student in the School of Pharmacy and the Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California.
Health Aff (Millwood). 2018 Aug;37(8):1200-1207. doi: 10.1377/hlthaff.2018.0154.
Diabetes is a top contributor to the avoidable burden of disease. Costly diabetes medications, including insulin and drugs from newer medication classes, can be inaccessible to people who lack insurance coverage. In 2014 and 2015 twenty-nine states and the District of Columbia expanded eligibility for Medicaid among low-income adults. To examine the impacts of Medicaid expansion on access to diabetes medications, we analyzed data on over ninety-six million prescription fills using Medicaid insurance in the period January 2008-December 2015. Medicaid eligibility expansions were associated with thirty additional Medicaid diabetes prescriptions filled per 1,000 population in 2014-15, relative to states that did not expand Medicaid eligibility. Age groups with higher prevalence of diabetes exhibited larger increases. The increase in prescription fills grew significantly over time. Overall, fills for insulin and for newer medications increased by 40 percent and 39 percent, respectively. Our findings suggest that Medicaid eligibility expansions may address gaps in access to diabetes medications, with increasing effects over time.
糖尿病是导致疾病负担不可避免增加的主要原因之一。对于没有保险覆盖的人群来说，包括胰岛素和新型药物在内的昂贵糖尿病药物可能无法获得。2014 年和 2015 年，29 个州和哥伦比亚特区扩大了对低收入成年人的医疗补助资格。为了研究医疗补助扩大对获得糖尿病药物的影响，我们分析了 2008 年 1 月至 2015 年 12 月期间使用医疗补助保险的超过 9600 万份处方的数据。与没有扩大医疗补助资格的州相比，2014-15 年，每 1000 人增加了 30 份额外的医疗补助糖尿病处方。糖尿病患病率较高的年龄组增加幅度更大。处方数量的增加随着时间的推移显著增长。总体而言，胰岛素和新型药物的处方量分别增加了 40%和 39%。我们的研究结果表明，扩大医疗补助资格可能有助于解决获得糖尿病药物的差距，并且这种影响随着时间的推移而增加。
