Alrasheed Marwan, Alsuhibani Abdulrahman, Balkhi Bander, Guo Jeff Jianfei
Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P.O. Box 2454, Riyadh 11451, Saudi Arabia.
James L. Winkle College of Pharmacy, University of Cincinnati Academic Health Center, Cincinnati, OH 45267, USA.
Healthcare (Basel). 2023 Aug 11;11(16):2265. doi: 10.3390/healthcare11162265.
Multiple myeloma (MM) is the most common plasma cell tumor type. In late 2015, the FDA approved three new medications for MM. These medications were ixazomib, daratumumab, and elotuzumab. However, their utilization, reimbursement, and price in the Medicaid program have not been analyzed before.
A retrospective drug utilization study using the national Medicaid pharmacy claims data from 2016 to 2022 in the US. The primary metrics of analysis were utilization (number of prescriptions), reimbursement (total spending), and price (reimbursement per prescription).
The overall Medicaid utilization of MM medications increased from 1671 prescriptions in 2016 to 34,583 prescriptions in 2022 (1970% increase). Moreover, the overall Medicaid reimbursement for the new MM medications increased from USD 9,250,000 in 2016 to over USD 214,449,000 in 2022 (2218% increase). Daratumumab had much higher utilization, reimbursement, and market shares than its competitors. Ixazomib was the most expensive medication compared to daratumumab and elotuzumab.
The results of this study demonstrate that CMS utilization and spending on MM medications have significantly grown since 2016. Daratumumab has by far the highest utilization, spending, and market share. The utilization of and spending on specific pharmaceuticals are clearly impacted by policy and clinical guideline recommendations.
多发性骨髓瘤（MM）是最常见的浆细胞肿瘤类型。2015年末，美国食品药品监督管理局（FDA）批准了三种用于治疗MM的新药。这些药物分别是伊沙佐米、达雷妥尤单抗和埃罗妥珠单抗。然而，此前尚未对它们在医疗补助计划中的使用情况、报销情况和价格进行分析。
采用美国2016年至2022年全国医疗补助药房报销数据进行回顾性药物利用研究。分析的主要指标为使用情况（处方数量）、报销情况（总支出）和价格（每张处方的报销金额）。
MM药物的总体医疗补助使用量从2016年的1671张处方增加到2022年的34583张处方（增长了1970%）。此外，MM新药的总体医疗补助报销金额从2016年的925万美元增加到2022年的超过2.14449亿美元（增长了2218%）。达雷妥尤单抗的使用量、报销金额和市场份额远高于其竞争对手。与达雷妥尤单抗和埃罗妥珠单抗相比，伊沙佐米是最昂贵的药物。
本研究结果表明，自2016年以来，医疗保险和医疗补助服务中心（CMS）在MM药物上的使用量和支出显著增加。达雷妥尤单抗的使用量、支出和市场份额目前是最高的。特定药品的使用和支出显然受到政策和临床指南建议的影响。
