Bloom B S, Jacobs J
Med Care. 1985 Jul;23(7):872-80. doi: 10.1097/00005650-198507000-00004.
This article examines the cost effects of a closed pharmaceutical formulary on Medicaid expenditures for peptic ulcer disease. Studies were performed before and after the imposition of a closed pharmaceutical formulary and indicated that total Medicaid costs for peptic ulcer treatment were 15.0% lower during the closed formulary than open formulary periods. The overall savings were due mainly to a sharp decline in the number of peptic ulcer patients served by Medicaid. The cost per patient-month of therapy increased by 9.4% between study periods. Pharmaceutical costs per patient-month declined by 78.9%, monthly physician payments increased by 3.1%, and monthly inpatient hospital costs increased by 23.6%. The small, short-term savings may be negated by increased expenditures in the near future when sicker patients, previously denied peptic ulcer drug treatment, may reenter the Medicaid system in need of expensive inhospital treatment.
本文探讨了封闭式药品处方集对医疗补助计划中消化性溃疡疾病支出的成本影响。在实施封闭式药品处方集之前和之后均进行了研究，结果表明，与开放式处方集时期相比，封闭式处方集期间医疗补助计划用于消化性溃疡治疗的总成本降低了15.0%。总体节省主要归因于医疗补助计划所服务的消化性溃疡患者数量急剧下降。两个研究时期之间，每位患者每月的治疗成本增加了9.4%。每位患者每月的药品成本下降了78.9%，每月医生诊疗费用增加了3.1%，每月住院医院成本增加了23.6%。以前被拒绝给予消化性溃疡药物治疗的病情较重患者，可能在不久的将来重新进入医疗补助系统，需要昂贵的住院治疗，这可能会抵消短期内的少量节省。
