联邦 340B 药品折扣计划中的特殊药物价格趋势。
Specialty Drug Price Trends in the Federal 340B Drug Discount Program.
机构信息
1 University of Southern California School of Pharmacy, Los Angeles.
2 PharMedQuest Pharmacy Services, Brea, California.
出版信息
J Manag Care Spec Pharm. 2019 Feb;25(2):178-187. doi: 10.18553/jmcp.2019.25.2.178.
BACKGROUND
The federal 340B Drug Discount Program provides access to significant drug price discounts for health care organizations in the United States that serve a disproportional share of disadvantaged patients.
OBJECTIVE
To analyze trends over a 10-year period (2006~2016) in the price of specialty drugs, contrasting the market price with the price paid under the 340B program.
METHODS
Pharmacy purchase records, including the 340B drug price and the wholesale acquisition cost (WAC), were collected from a 340B-contract pharmacy group in Southern California between 2006 and 2016. Records were used to calculate price changes in the annual average price paid. The average price was calculated as the weighted price, using purchasing volume for each year as weights. Separate time series of year-to-year price changes were created by therapeutic class using the American Hospital Formulary Service Therapeutic Classification system.
RESULTS
The 340B price growth rate patterns were similar to the profile of the WAC prices over time across all drug classes. The overall drug price growth rate per year over 10 years for WAC prices was 15% and 10% for 340B prices. For specialty drug classes, the average growth rates per year were 14% for the WAC price and 6% for the 340B price. For certain specialty drug classes, such as antineoplastic and antiretroviral drugs, the 340B price inflation rates were significantly lower than the WAC price inflation rates after 2013.
CONCLUSIONS
The price inflation of specialty drugs exceeds the rate of inflation in the Consumer Price Index for prescription drugs. The 340B price shows a similar inflation pattern as the WAC price over time in the specialty drug categories.
DISCLOSURES
This study is 1 of 3 research projects that comprise Lee's dissertation. Funding to support Lee's dissertation research was provided as an unrestricted fellowship from PharMedQuest Pharmacy Services. Chang is employed by PharMedQuest Pharmacy Services, which provided the dataset for analysis. Lee reports grants from PharMedQuest Pharmacy Services, unrelated to this study. McCombs has nothing to report.
背景
联邦 340B 药品折扣计划为美国的医疗保健组织提供了获得大量药品折扣的机会，这些组织为处境不利的患者提供了不成比例的服务。
目的
分析在 10 年期间（2006~2016 年），特殊药物的价格趋势，对比市场价格和 340B 计划下的支付价格。
方法
从加利福尼亚州南部的一家 340B 合同药房收集了 2006 年至 2016 年的药房购买记录，包括 340B 药品价格和批发采购成本（WAC）。使用这些记录计算每年平均支付价格的价格变化。平均价格是使用每年的采购量作为权重的加权价格。根据美国医院配方服务治疗分类系统，使用治疗类别创建了每年价格变化的单独时间序列。
结果
在所有药物类别中，340B 价格增长率模式与 WAC 价格随时间的变化趋势相似。10 年来，WAC 价格的年药品价格增长率为 15%，340B 价格为 10%。对于特殊药物类别，WAC 价格的年平均增长率为 14%，340B 价格为 6%。对于某些特殊药物类别，如抗肿瘤药和抗逆转录病毒药物，2013 年后，340B 价格的通胀率明显低于 WAC 价格的通胀率。
结论
特殊药物的价格通胀超过了处方药消费者价格指数的通胀率。340B 价格在特殊药物类别中随时间的变化趋势与 WAC 价格相似。
披露
这项研究是 Lee 博士论文的 3 个研究项目之一。支持 Lee 博士论文研究的资金是 PharMedQuest Pharmacy Services 提供的一项无限制奖学金。Chang 受雇于 PharMedQuest Pharmacy Services，该公司提供了用于分析的数据。Lee 报告说 PharMedQuest Pharmacy Services 有与其无关的研究资金。McCombs 没有要报告的内容。
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