From The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST) (A.V.G.), College of Medicine, and Department of Neurology (C.C.L., K.K., J.F.B.), Division of Health Services Research, Wexner Medical Center, The Ohio State University, Columbus; Department of Epidemiology and Biostatistics (E.L.R.), Michigan State University, East Lansing; and Department of Neurology (B.C.C.), University of Michigan, Ann Arbor.
Neurology. 2024 Nov 26;103(10):e210029. doi: 10.1212/WNL.0000000000210029. Epub 2024 Oct 30.
To observe medication cost trends for 5 common neurologic conditions.
We quantified annual out-of-pocket (OOP) and total medication costs for patients seen by a neurologist with epilepsy, multiple sclerosis (MS), Parkinson disease (PD), peripheral neuropathy (PN), and dementia/Alzheimer's disease in a commercial claims database cross-sectionally from 2012 to 2021.
We identified 186,144 patients with epilepsy, 54,676 with MS, 45,909 with PD, 169,127 with PN, and 60,861 with dementia/Alzheimer. OOP costs for MS medications increased each year, by 217% on average. Branded epilepsy medications had higher OOP costs than generics. Decreases ranging from 48% to 80% in annual OOP costs of duloxetine, pregabalin, rasagiline, rivastigmine, and memantine were observed in the years after generic introduction.
Preferentially selecting generic medications reduces OOP costs, other than for MS where costs continue to increase. Policy solutions, such as cost caps, are needed.
观察 5 种常见神经系统疾病的药物费用趋势。
我们在一个商业索赔数据库中，从 2012 年到 2021 年，对一位神经科医生治疗的癫痫、多发性硬化症（MS）、帕金森病（PD）、周围神经病（PN）和痴呆/阿尔茨海默病患者的年度自付（OOP）和总药物费用进行了量化。
我们确定了 186144 例癫痫患者、54676 例 MS 患者、45909 例 PD 患者、169127 例 PN 患者和 60861 例痴呆/阿尔茨海默病患者。MS 药物的 OOP 成本每年都在增加，平均增长 217%。与仿制药相比，品牌癫痫药物的 OOP 成本更高。在仿制药推出后的几年里，度洛西汀、普瑞巴林、雷沙吉兰、利伐斯的明和盐酸美金刚的年 OOP 成本分别下降了 48%至 80%。
优先选择仿制药可以降低 OOP 成本，但 MS 除外，其成本仍在继续增加。需要采取成本上限等政策解决方案。
