Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
American Medical Association, Chicago, Illinois.
Am J Prev Med. 2022 Jun;62(6):e351-e355. doi: 10.1016/j.amepre.2021.11.021. Epub 2022 Mar 28.
Smoking is the leading cause of preventable disease and death. However, effective medicines, including prescription medications often covered by health insurance, are available to aid cessation.
Trends of 7 U.S. Food and Drug Administration-approved prescription medications for smoking cessation during 2009-2019 (before and during Affordable Care Act implementation), including fill counts and spending (total and patient, adjusted to 2019 U.S. dollars), were assessed among U.S. adults aged ≥18 years. Symphony Health's Integrated Dataverse combines data on >90% of outpatient prescription fills with market purchasing data to create national estimates. Analyses were conducted in 2021.
Annually, total fills (spending) decreased from 3.7 million ($577 million) in 2009 to 2.5 million ($465 million) in 2013 and increased to 4.5 million ($1.279 billion) in 2019; patient spending decreased from $174 million (30% of total annual spending) in 2009 to $54 million (4%) in 2019. Comparing 2009 with 2019, the total spending per fill increased by 80% (from $157 to $282), whereas patient spending per fill decreased by 75% (from $47 to $12). The total spending per fill for branded products increased by 175% (from $166 to $459) and decreased by 41% (from $75 to $44) for generic products. Branded product percentage decreased from 89% to 57%.
Total fills and spending decreased from 2009 to 2013 and then increased through 2019, whereas patient spending decreased. Earlier studies suggest possible reasons for these trends, such as gradual implementation of federal requirements for insurance coverage of cessation medications and reduced cost sharing and financial barriers.
吸烟是可预防疾病和死亡的主要原因。然而，包括通常由健康保险覆盖的处方药物在内，有有效的药物可帮助戒烟。
评估了 2009 年至 2019 年（平价医疗法案实施之前和实施期间）美国食品和药物管理局批准的 7 种用于戒烟的处方药物在美国≥18 岁成年人中的趋势，包括填用量和支出（总支出和患者支出，调整为 2019 年的美元）。Symphony Health 的综合数据库结合了超过 90%的门诊处方填写数据和市场采购数据，以创建全国估计值。分析于 2021 年进行。
每年，总填用量（支出）从 2009 年的 370 万（5.77 亿美元）降至 2013 年的 250 万（4.65 亿美元），并在 2019 年增至 450 万（12.79 亿美元）；患者支出从 2009 年的 1.74 亿美元（占总年度支出的 30%）降至 2019 年的 5400 万美元（4%）。与 2009 年相比，每剂的总支出增加了 80%（从 157 美元增至 282 美元），而每剂的患者支出下降了 75%（从 47 美元降至 12 美元）。品牌产品的总支出每剂增加了 175%（从 166 美元增至 459 美元），通用产品的支出减少了 41%（从 75 美元降至 44 美元）。品牌产品的比例从 89%降至 57%。
从 2009 年到 2013 年，填用量和支出减少，然后在 2019 年增加，而患者支出减少。早期研究表明了这些趋势的可能原因，例如联邦对戒烟药物保险覆盖的要求逐渐实施，以及成本分担和财务障碍的减少。
