美国有雇主提供医疗保险的成年人在 2010 年和 2017 年对戒烟药物的使用和支出情况。
Receipt of and Spending on Cessation Medication Among US Adults With Employer-Sponsored Health Insurance, 2010 and 2017.
机构信息
1242 Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
出版信息
Public Health Rep. 2021 Nov-Dec;136(6):736-744. doi: 10.1177/0033354920984155. Epub 2021 Feb 18.
OBJECTIVE
Studies examining the use of smoking cessation treatment and related spending among enrollees with employer-sponsored health insurance are dated and limited in scope. We assessed changes in annual receipt of and spending on cessation medications approved by the US Food and Drug Administration (FDA) among tobacco users with employer-sponsored health insurance from 2010 to 2017.
METHODS
We analyzed data on 439 865 adult tobacco users in 2010 and 344 567 adult tobacco users in 2017 from the IBM MarketScan Commercial Database. We used a negative binomial regression to estimate changes in receipt of cessation medication (number of fills and refills and days of supply). We used a generalized linear model to estimate spending (total, employers', and out of pocket). In both models, covariates included year, age, sex, residence, and type of health insurance plan.
RESULTS
From 2010 to 2017, the percentage of adult tobacco users with employer-sponsored health insurance who received any cessation medication increased by 2.4%, from 15.7% to 16.1% ( < .001). Annual average number of fills and refills per user increased by 15.1%, from 2.5 to 2.9 ( < .001) and days of supply increased by 26.4%, from 81.9 to 103.5 ( < .001). The total annual average spending per user increased by 53.6%, from $286.40 to $440.00 ( < .001). Annual average out-of-pocket spending per user decreased by 70.9%, from $70.80 to $20.60 ( < .001).
CONCLUSIONS
Use of smoking cessation medications is low among smokers covered by employer-sponsored health insurance. Opportunities exist to further increase the use of cessation medications by promoting the use of evidence-based cessation treatments and reducing barriers to coverage, including out-of-pocket costs.
目的
研究使用戒烟治疗和与雇主赞助的健康保险相关的支出的研究已经过时，并且范围有限。我们评估了 2010 年至 2017 年间，有雇主赞助的健康保险的烟草使用者中，获得美国食品和药物管理局 (FDA) 批准的戒烟药物的年度使用情况和支出变化。
方法
我们分析了 2010 年和 2017 年 IBM MarketScan 商业数据库中 439865 名成年烟草使用者和 344567 名成年烟草使用者的数据。我们使用负二项回归估计戒烟药物的使用情况（用药次数和用药剂量，以及用药天数）变化。我们使用广义线性模型来估计支出（总支出、雇主支出和自付支出）。在这两种模型中，协变量包括年份、年龄、性别、居住地点和健康保险计划类型。
结果
从 2010 年至 2017 年，有雇主赞助的健康保险的成年烟草使用者中使用任何戒烟药物的比例增加了 2.4%，从 15.7%增加到 16.1%（<0.001）。每个用户的年平均用药次数和剂量增加了 15.1%，从 2.5 次增加到 2.9 次（<0.001），用药天数增加了 26.4%，从 81.9 天增加到 103.5 天（<0.001）。每位用户的年度平均总支出增加了 53.6%，从 286.40 美元增加到 440.00 美元（<0.001）。每位用户的年平均自付支出减少了 70.9%，从 70.80 美元减少到 20.60 美元（<0.001）。
结论
在有雇主赞助的健康保险覆盖的吸烟者中，戒烟药物的使用情况较低。有机会通过推广使用基于证据的戒烟治疗方法和减少覆盖障碍（包括自付费用），进一步增加戒烟药物的使用。
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