载脂蛋白转化酶枯草溶菌素 9 抑制剂上市后降脂治疗药物在医疗保险和医疗补助方面的全国性支出变化。
Changes in nationwide Medicare and Medicaid expenditures on lipid-lowering therapies after proprotein convertase/subtilisin type 9 inhibitor availability.
机构信息
Department of Pharmacy Services, Brigham and Women's Hospital, Boston MA, USA.
Department of Pharmacy Services, Brigham and Women's Hospital, Boston MA, USA.
出版信息
J Clin Lipidol. 2020 May-Jun;14(3):315-321.e4. doi: 10.1016/j.jacl.2020.04.003. Epub 2020 Apr 13.
BACKGROUND
Several advances in lipid-lowering pharmacotherapy and changes in generic formulation availability occurred between 2013 and 2017.
OBJECTIVE
We sought to examine nationwide trends in Medicare Part D and Medicaid expenditures on lipid-lowering therapies from 2013 to 2017.
METHODS
We aggregated 662.2 million Medicare Part D and Medicaid prescription claims with associated expense data for 2013 to 2017 from the Medicare and Medicaid Drug Spending Dashboards for nine therapeutic classes of lipid-lowering therapies.
RESULTS
Total Medicare Part D expenditures on lipid-lowering therapies was $7.01 billion in 2013 and $5.07 billion in 2017. Total Medicaid lipid-lowering therapy expenditures decreased from $440.9 million in 2013 to $398.7 million in 2017. Annual Medicare expenditures on Crestor were $2.2 billion in 2013 and $0.31 billion in 2017. Annual Medicaid Crestor expenditures decreased from $92.4 million in 2013 to $30.1 million in 2017. From 2013 to 2016, Medicare expenditures on Zetia decreased from $0.89 billion to $0.70 billion, whereas Medicaid Zetia expenditures decreased from $38.6 million in 2013 to $25.4 million in 2017. In 2017, PCSK9 inhibitors accounted for $317.3 million and $14.2 million in Medicare and Medicaid expenditures, respectively.
CONCLUSIONS
Overall Medicare and Medicaid expenditures on lipid-lowering therapies decreased by $2.5 billion from 2013 to 2017.
背景
2013 年至 2017 年间，降脂药物治疗方面取得了多项进展，仿制药的供应情况也发生了变化。
目的
我们旨在研究 2013 年至 2017 年期间，医疗保险处方药计划（Medicare Part D）和医疗补助计划（Medicaid）在降脂治疗方面的支出趋势。
方法
我们从 Medicare 和 Medicaid 药物支出数据看板中汇总了 2013 年至 2017 年期间九个降脂治疗药物治疗类别的 6.622 亿份 Medicare Part D 和 Medicaid 处方药索赔及其相关费用数据。
结果
2013 年，医疗保险处方药计划用于降脂治疗的总支出为 70.1 亿美元，而 2017 年为 50.7 亿美元。2013 年，医疗补助降脂治疗支出为 4.409 亿美元，2017 年降至 3.987 亿美元。2013 年，医疗保险处方立普妥的年支出为 22 亿美元，而 2017 年仅为 3.1 亿美元。2013 年，医疗补助立普妥的年支出为 9240 万美元，而 2017 年仅为 3010 万美元。从 2013 年至 2016 年，医疗保险处方依折麦布的支出从 8.9 亿美元降至 7 亿美元，而医疗补助依折麦布的支出从 2013 年的 3860 万美元降至 2017 年的 2540 万美元。2017 年，PCSK9 抑制剂在医疗保险和医疗补助计划中的支出分别为 3.173 亿美元和 1420 万美元。
结论
2013 年至 2017 年期间，医疗保险和医疗补助计划用于降脂治疗的总支出减少了 25 亿美元。
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