1996 年至 2018 年美国邮购药店使用趋势：医疗支出面板调查分析。
Trends in Mail-Order Pharmacy Use in the U.S. From 1996 to 2018: An Analysis of the Medical Expenditure Panel Survey.
机构信息
Division of Primary Care and Population Health, Department of Medicine, Stanford School of Medicine, Stanford University, Palo Alto, California; Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany.
Division of Primary Care and Population Health, Department of Medicine, Stanford School of Medicine, Stanford University, Palo Alto, California; Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany.
出版信息
Am J Prev Med. 2021 Aug;61(2):e63-e72. doi: 10.1016/j.amepre.2021.02.017. Epub 2021 May 3.
INTRODUCTION
The use of mail-order pharmacies is generally associated with lower healthcare costs and improved medication adherence. To promote the use of mail-order pharmacies, it is important to understand the time trends in their use and whether these trends vary by population subgroups.
METHODS
This study used the 1996-2018 Medical Expenditure Panel Survey to determine the annual prevalence of mail-order pharmacy use (defined as purchasing ≥1 prescription from a mail-order or online pharmacy) among U.S. adult prescription users and its variation by population characteristics. Logistic regression was used to determine the correlates of mail-order pharmacy use. Results were presented for medications and therapeutic classes most commonly purchased by mail-order pharmacy exclusive users. Analyses were conducted in December 2020.
RESULTS
The annual prevalence of mail-order pharmacy use among U.S. adult prescription users increased from 10.2% (95% CI=9.3, 11.1) in 1996 to 17.0% (95% CI=15.9, 18.1) in 2005 and then declined to 15.7% (95% CI=14.9, 16.6) by 2018. Absolute differences in the prevalence of use by race/ethnicity, education, and health insurance coverage widened over time, whereas they remained stable when stratifying by sex, age, marital status, region, limitations in daily activities, pain interference, health status, number of chronic conditions, and access to medical care. Among mail-order pharmacy exclusive users, the 3 most commonly purchased medications were atorvastatin (16.7%), levothyroxine (13.6%), and lisinopril (13.1%); the 3 most commonly purchased therapeutic classes were cardiovascular agents (57.9%), metabolic agents (52.1%), and central nervous system agents (29.6%).
CONCLUSIONS
The prevalence of mail-order pharmacy use has declined in recent years and has shown significant variation across population subgroups. Future research should examine whether the declining trends and variation in use may influence the management of chronic conditions and the disparities in health and healthcare costs.
简介
邮购药店的使用通常与降低医疗成本和提高药物依从性有关。为了促进邮购药店的使用，了解其使用的时间趋势以及这些趋势是否因人群亚组而异非常重要。
方法
本研究使用 1996 年至 2018 年的医疗支出面板调查，确定美国成年处方药使用者中邮购药店使用（定义为从邮购或在线药店购买≥1 种处方）的年度流行率及其随人口特征的变化。使用逻辑回归确定邮购药店使用的相关性。结果以邮购药店专用用户最常购买的药物和治疗类别呈现。分析于 2020 年 12 月进行。
结果
在美国成年处方药使用者中，邮购药店使用的年度流行率从 1996 年的 10.2%（95%CI=9.3,11.1）上升到 2005 年的 17.0%（95%CI=15.9,18.1），然后在 2018 年下降到 15.7%（95%CI=14.9,16.6）。按种族/民族、教育程度和医疗保险覆盖范围划分的使用流行率的绝对差异随时间扩大，而按性别、年龄、婚姻状况、地区、日常活动受限、疼痛干扰、健康状况、慢性病数量和获得医疗保健的情况分层时则保持稳定。在邮购药店专用用户中，最常购买的 3 种药物是阿托伐他汀（16.7%）、左甲状腺素（13.6%）和赖诺普利（13.1%）；最常购买的 3 个治疗类别是心血管药物（57.9%）、代谢药物（52.1%）和中枢神经系统药物（29.6%）。
结论
近年来，邮购药店的使用有所减少，并且在人群亚组之间存在显著差异。未来的研究应该检查使用减少的趋势和变化是否会影响慢性病的管理以及健康和医疗成本的差异。
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