Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore.
Associate Professor of Medicine, University of Maryland School of Medicine, Baltimore.
J Manag Care Spec Pharm. 2021 Dec;27(12):1744-1749. doi: 10.18553/jmcp.2021.27.12.1744.
Chronic obstructive pulmonary disease (COPD) and asthma are common respiratory diseases that impose a significant economic burden on Medicaid. Inhalers are the mainstay treatment for relieving symptoms and improving outcomes for COPD and asthma patients. To describe the total spending and trends of Medicaid expenditures on inhalers between 2012 and 2018 in the United States. We analyzed the deidentified data from the Medicaid Drug Spending Dashboard and utilization datasets from 2012 to 2018. We identified 9 classes of inhalers and described the Medicaid total spending on and relative annual changes for those inhalers. We also described the spending on available generic inhalers and compared the Medicaid spending by manufacturers during this time frame. Medicaid spent $26.2 billion on inhalers from 2012 to 2018. This spending increased by $2.5 billion (120%) over this time frame. During this specified period, the highest Medicaid spending was on the group of inhaled corticosteroid (ICS)-containing inhalers ($14.9 billion). Within this group, the inhaler class of ICS/long-acting beta-2 adrenoceptor agonists contributed to the highest Medicaid spending (53%), with a growth of 607% between 2012 and 2018. Of the $26.2 billion that Medicaid spent on inhalers, $35.5 million (less than 0.01%) was spent on 2 generic inhalers: fluticasone propionate with salmeterol and levalbuterol tartrate hydrofluoroalkane. Between 2012 and 2018, on average, $3.5 billion per year was spent by Medicaid on inhalers. Decreasing the price of inhalers by introducing more generic inhalers in the market can potentially reduce the cost burden on Medicaid. : This study was funded by the American Foundation for Pharmaceutical Education (AFPE). The funders had no role in study design, data collection, and analysis, decision to publish, or preparation of the manuscript. The authors declare no conflicts of interest.
慢性阻塞性肺疾病（COPD）和哮喘是常见的呼吸道疾病，给医疗补助计划带来了巨大的经济负担。吸入器是缓解 COPD 和哮喘患者症状和改善预后的主要治疗方法。本研究旨在描述 2012 年至 2018 年期间，美国医疗补助计划在吸入器上的总支出和趋势。我们分析了 2012 年至 2018 年期间来自医疗补助药物支出仪表板和利用数据集的匿名数据。我们确定了 9 类吸入器，并描述了这些吸入器的医疗补助总支出和相对年度变化。我们还描述了可用通用吸入器的支出情况，并比较了在此期间制造商的医疗补助支出情况。2012 年至 2018 年，医疗补助计划在吸入器上的支出为 262 亿美元。在此期间，这一支出增加了 25 亿美元（增长 120%）。在这段时间内，医疗补助计划在含有吸入性皮质类固醇（ICS）的吸入器（149 亿美元）上的支出最高。在这一组中，ICS/长效β2 肾上腺素能受体激动剂的吸入器类别的支出最高（占 53%），2012 年至 2018 年间增长了 607%。在医疗补助计划在吸入器上的 262 亿美元支出中，只有 3550 万美元（不到 0.01%）用于 2 种通用吸入器：丙酸氟替卡松和沙美特罗以及酒石酸氢氟烷。2012 年至 2018 年间，医疗补助计划平均每年在吸入器上支出 35 亿美元。通过在市场上推出更多的通用吸入器来降低吸入器的价格，有可能减轻医疗补助计划的成本负担。本研究由美国制药教育基金会（AFPE）资助。资助者在研究设计、数据收集和分析、出版决定或手稿准备过程中没有任何作用。作者声明没有利益冲突。
