Taliaferro Leah M, Dodson Sarah, Norton Melissa C, Ofei-Dodoo Samuel
Ascension Via Christi Hospitals Wichita, Inc., 929 N Saint Francis, Wichita, KS 67214, United States.
Ascension Via Christi Hospitals, 1 Mt Carmel Pl, Pittsburg, KS 66762, United States.
Explor Res Clin Soc Pharm. 2023 Jun 14;11:100295. doi: 10.1016/j.rcsop.2023.100295. eCollection 2023 Sep.
The federal 340B drug program was designed to stretch scarce federal resources to provide more comprehensive services for more eligible patients. To help satisfy community needs, 340B Prescription Assistance Programs (PAPs) allow eligible patients to access medications at significantly reduced costs.
To measure the impact of reduced-cost medications for chronic obstructive pulmonary disease (COPD) through a 340B PAP on all-cause hospitalizations and emergency department visits.
This multi-site, retrospective, single-sample, pre-post cohort study involved patients with COPD who used a 340B PAP to fill prescriptions for an inhaler or nebulizer between April 1, 2018, and June 30, 2019. Data from included subjects were evaluated and compared in the year before and after each individual patient's respective prescription fill in the 340B PAP. The primary outcome evaluated the impact of 340B PAP on all-cause hospitalizations and emergency department visits. Secondary outcomes evaluated the financial impact associated with program use. Wilcoxon signed-rank test was utilized to assess changes in the outcome measures.
Data for 115 patients were included in the study. Use of the 340B PAP resulted in a significant reduction in the composite mean number of all-cause hospitalizations and emergency department visits (2.42 vs 1.66, Z = -3.12, = 0.002). There was an estimated $1012.82 mean cost avoidance per patient due to reduction in healthcare utilization. Annual program-wide prescription cost savings for patients totaled $178,050.21.
This study suggested that access to reduced-cost medications through the federal 340B Drug Pricing Program was associated with a significant reduction in hospitalizations and emergency department visits for patients with COPD, decreasing patients' utilization of healthcare resources.
联邦340B药品计划旨在拓展稀缺的联邦资源，以便为更多符合条件的患者提供更全面的服务。为满足社区需求，340B处方援助计划（PAPs）允许符合条件的患者以大幅降低的成本获取药物。
通过340B PAP来衡量降低成本的慢性阻塞性肺疾病（COPD）药物对全因住院和急诊就诊的影响。
这项多中心、回顾性、单样本、前后队列研究纳入了在2018年4月1日至2019年6月30日期间使用340B PAP来开具吸入器或雾化器处方的COPD患者。对纳入研究对象的数据在每位患者于340B PAP中各自开具处方之前和之后的年份进行评估和比较。主要结局评估340B PAP对全因住院和急诊就诊的影响。次要结局评估与项目使用相关的财务影响。采用Wilcoxon符号秩检验来评估结局指标的变化。
115例患者的数据纳入了本研究。使用340B PAP导致全因住院和急诊就诊的综合平均次数显著减少（2.42对1.66，Z = -3.12，P = 0.002）。由于医疗保健利用率降低，估计每位患者平均节省成本1012.82美元。患者每年在项目范围内的处方成本节省总计178,050.21美元。
本研究表明，通过联邦340B药品定价计划获取降低成本的药物与COPD患者住院和急诊就诊次数显著减少相关，降低了患者对医疗资源的利用率。
