Association between Higher Generic Drug Use and Medicare Part D Star Ratings: An Observational Analysis.
Association between Higher Generic Drug Use and Medicare Part D Star Ratings: An Observational Analysis.
复制标题
较高仿制药使用与医疗保险 D 部分星级评级之间的关联：观察分析。
DOI：
10.1016/j.jval.2018.03.005
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发表时间：
2018
期刊：
影响因子：
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通讯作者：
Qian,Jingjing
中科院分区：
文献类型：
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作者：
Hohmann,Natalie;Hansen,Richard;Garza,KimberlyB;Harris,Ilene;Kiptanui,Zippora;Qian,Jingjing
背景由于成本节约和药物获取的潜力，是Medicare处方药计划实现高星星评级和提高Medicare受益人计划产品质量的可行考虑因素。目的研究合同级仿制药分配比例（pGDD）MethodsThis是一项回顾性研究，将2011年Medicare Part D星星评级数据与合同级pGDD数据相关联。其中包括477份个人医疗保险处方合同，占处方药计划总数的75%，占2010年底可用的医疗保险优势处方药计划总数的65%以上。主要结果是医疗保险D部分摘要和领域星星评级（1-5表示最低到最高的性能），包括一系列的质量指标的访问，成本，受益人的满意度，卫生服务的结果和过程。有序逻辑回归模型用于检查pGDD和医疗保险D部分总结和领域星星评级之间的关联，结果较高的pGDD与较高的汇总星星评级相关（调整后的比值比为1.08，95%置信区间为1.04-1.12）和更高的“药物计划会员体验”领域评级（调整后的比值比1.07，95%置信区间1.03-1.11）。ConclusionsPrescription formulary福利设计的目标是增加仿制药的使用似乎与改善会员的经验和更高的计划星星评级。可以考虑将pGDD纳入医疗保险D部分星星评级措施，以提高处方计划的质量。
BackgroundIncreasing generic drug use, due to potential for cost savings and drug access, is a viable consideration for Medicare prescription drug plans to achieve high star ratings and improve quality of plan offerings for Medicare beneficiaries.ObjectiveTo examine the association between contract-level proportion of generic drugs dispensed (pGDD) and Medicare Part D star ratings.MethodsThis was a retrospective study of linked 2011 Medicare Part D star rating data with contract-level pGDD data. A total of 477 individual Medicare prescription contracts were included, representing 75% of total Prescription Drug Plans and more than 65% of total Medicare Advantage Prescription Drug Plans available by the end of 2010. Primary outcomes were Medicare Part D summary and domain star ratings (1–5 indicating lowest to highest performance), incorporating a range of quality measures for access, cost, beneficiary satisfaction, and health services outcomes and processes. Ordinal logistic regression models were used to examine associations between pGDD and Medicare Part D summary and domain star ratings, controlling for contract type and number of beneficiary enrollment.ResultsHigher pGDD was associated with higher summary star ratings (adjusted odds ratio 1.08 with 95% confidence interval 1.04–1.12) and higher “member experience with drug plan” domain ratings (adjusted odds ratio 1.07 with 95% confidence interval 1.03–1.11).ConclusionsPrescription formulary benefit design targeting increasing generic drug use appears to be associated with improved member experience and higher plan star ratings. Consideration may be given to incorporating pGDD into Medicare Part D star rating measures to improve quality of prescription plans.