Borrelli Eric P, Saad Peter, Barnes Nathan E, Dumitru Doina, Lucaci Julia D
Health Economics & Outcomes Research (HEOR), Becton, Dickinson and Company, San Diego, CA, USA.
Medical Affairs, Becton, Dickinson and Company, Durham, NC, USA.
Clinicoecon Outcomes Res. 2024 Oct 3;16:733-745. doi: 10.2147/CEOR.S480890. eCollection 2024.
To model the potential clinical and economic impact of blister-packaging medications for chronic conditions on medication adherence and healthcare costs in a commercially insured population.
A health economic model was developed to evaluate the potential impact of blister-packaging chronic medications for a commercially insured population. The chronic medication classes assessed were renin-angiotensin-system (RAS) antagonists, statins, non-insulin oral antidiabetics, and direct oral anticoagulants (DOACs). The model was designed to reflect the perspective of a hypothetical commercially insured health plan with 100,000 members, over a one-year time horizon. Literature-based or best available epidemiologic references were used to inform the number of patients utilizing each medication class, the impact of blister-packaging on the number of patients who become adherent, as well as the impact of medication adherence in a commercially insured population on healthcare costs for each medication class assessed. Impact on costs was measured in total net healthcare costs, as well as being stratified by medical costs and medication costs.
Following the blister-packaging intervention, there were an additional 591 patients adherent to RAS antagonists, 1196 patients adherent to statins, 169 patients adherent to oral antidiabetics, and 25 patients adherent to DOACs. While pharmacy costs increased, these costs were more than offset by the reduction in medical costs. Overall, the increase in patients adherent to therapy due to blister-packaging led to a reduction in total healthcare costs of $879,312 for RAS antagonists (-$0.73 per-member per-month (PMPM)), $343,322 for statins (-$0.29 PMPM), $78,917 for oral antidiabetics (-$0.07 PMPM), and $120,793 for DOACs (-$0.10 PMPM).
Blister-packaging chronic medications in a commercially insured population has the potential to reduce healthcare costs. Future research is needed to confirm these findings in real-world settings and to fully understand the clinical and economic implications of blister-packaging chronic medications.
建立一个模型，以评估泡罩包装的慢性病药物对商业保险人群的药物依从性和医疗保健成本的潜在临床和经济影响。
开发了一个健康经济模型，以评估泡罩包装慢性病药物对商业保险人群的潜在影响。评估的慢性病药物类别包括肾素-血管紧张素系统（RAS）拮抗剂、他汀类药物、非胰岛素口服抗糖尿病药物和直接口服抗凝剂（DOACs）。该模型旨在反映一个假设的拥有10万名成员的商业保险健康计划在一年时间范围内的情况。基于文献或最佳可用的流行病学参考资料，用于确定使用每种药物类别的患者数量、泡罩包装对依从患者数量的影响，以及商业保险人群中药物依从性对所评估的每种药物类别的医疗保健成本的影响。对成本的影响以总净医疗保健成本来衡量，并按医疗成本和药物成本进行分层。
在泡罩包装干预后，额外有591名患者依从RAS拮抗剂治疗，1196名患者依从他汀类药物治疗，169名患者依从口服抗糖尿病药物治疗，25名患者依从DOACs治疗。虽然药房成本有所增加，但这些成本被医疗成本的降低所抵消。总体而言，由于泡罩包装导致的治疗依从患者数量增加，使得RAS拮抗剂的总医疗保健成本降低了879,312美元（-0.73美元/成员/月（PMPM）），他汀类药物降低了343,322美元（-0.29美元PMPM），口服抗糖尿病药物降低了78,917美元（-0.07美元PMPM），DOACs降低了120,793美元（-0.10美元PMPM）。
在商业保险人群中对慢性病药物进行泡罩包装有可能降低医疗保健成本。未来需要进行研究，以在实际环境中证实这些发现，并充分了解泡罩包装慢性病药物的临床和经济影响。
