威斯康星州针对低收入老年人的州药品援助计划的趋势
Trends in a State Pharmaceutical Assistance Program for Low-income Older Adults in Wisconsin.
作者信息
Look Kevin, Kim Nam Hyo, Dague Laura, Winn Aaron
机构信息
University of Wisconsin-Madison, School of Pharmacy.
Texas A&M University, Bush School of Government and Public Service.
出版信息
Innov Pharm. 2020 Nov 5;11(4). doi: 10.24926/iip.v11i4.3410. eCollection 2020.
INTRODUCTION
Many older adults face difficulty in affording their prescription drugs, despite having coverage available through Medicare Part D. SeniorCare is Wisconsin's pharmaceutical assistance program that provides comprehensive drug coverage for low-income older adults who are not eligible for full Medicaid benefits.
METHODS
We analyzed SeniorCare enrollment and pharmacy claims data from 2014 to 2018.
RESULTS
Total drug expenditures increased by 19.3%, with the proportion of expenditures paid by SeniorCare and members decreasing while the proportion paid by other payers increased. Specialty drugs accounted for a substantial and growing proportion of total expenditures (20.4% in 2018) despite accounting for <0.2% of all claims.
CONCLUSIONS
Total drug expenditures in SeniorCare have steadily increased over time, primarily due to rising average expenditures per drug fill and increased use of specialty drugs. However, SeniorCare members have been largely protected from these increases and have paid a decreasing proportion of costs over time.
引言
尽管许多老年人可通过医疗保险D部分获得保险，但仍有许多人在支付处方药费用方面面临困难。“老年护理计划”是威斯康星州的药品援助计划，为不符合全额医疗补助福利资格的低收入老年人提供全面的药品保险。
方法
我们分析了2014年至2018年“老年护理计划”的参保情况和药房报销数据。
结果
药品总支出增长了19.3%，“老年护理计划”和参保人支付的支出比例下降，而其他支付方支付的比例上升。专科药物在总支出中所占比例很大且不断增加（2018年为20.4%），尽管其在所有报销申请中所占比例不到0.2%。
结论
随着时间的推移，“老年护理计划”的药品总支出稳步增加，主要原因是每次药品配给的平均支出增加以及专科药物的使用增加。然而，“老年护理计划”的参保人在很大程度上免受了这些费用增加的影响，并且随着时间的推移支付的费用比例不断下降。
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