Working-age persons with multiple sclerosis and access to disease-modifying medications
Working-age persons with multiple sclerosis and access to disease-modifying medications
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DOI：
10.1177/1352458507080466
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发表时间：
2008-01-01
影响因子：
5.8
通讯作者：
Kinkel, R. P.
中科院分区：
文献类型：
--
作者：
Iezzoni, L. I.;Ngo, L. H.;Kinkel, R. P.
美国居民在获取处方药方面可能面临严重的经济障碍，包括治疗多发性硬化症 (MS) 的疾病缓解药物。我们对全国 983 名 21-64 岁的多发性硬化症患者进行了 30 分钟的电话调查，以探讨财务和健康保险问题如何影响获得包括多发性硬化症药物在内的服务。几乎每个人（96.3%）都有一些健康保险。多变量逻辑回归分析考虑了人口、疾病和保险特征。在 40 岁以下的人群中，只有 10.8% 从未接受过疾病缓解药物治疗，而 60-64 岁人群中这一比例为 41.1%。在没有保险的人中，36.8% 的人表示从未服用过这些药物，而有健康保险的人中这一比例为 21.2%。未投保者（与投保者相比）在过去 12 个月内使用这些药物的调整后比值比 (95% CI) 为 0.28 (0.08, 0.95)。超过 16% 的拥有公共卫生计划的人表示，他们的保险公司最初拒绝承保多发性硬化症药物。当被问及 MS 药物的总体情况时，22.3% 的人表示由于成本问题没有按处方配药、漏服或分药； 22.4% 的人“非常”担心在需要时获得多发性硬化症药物。很大一部分多发性硬化症患者在获取多发性硬化症药物方面面临着经济和健康计划相关的障碍。
US residents can face serious financial barriers to obtaining prescription medications, including disease-modifying medications for multiple sclerosis ( MS). We conducted 30-min telephone surveys with 983 persons with MS nationwide, 21-64 years old, to explore how financial and health insurance concerns affect access to services including MS drugs. Almost everyone (96.3%) had some health insurance. Multivariable logistic regression analyses accounted for demographic, disease and insurance characteristics. Only 10.8% of those < 40 years old had never received disease-modifying medications, compared with 41.1% of persons aged 60-64. Among the uninsured, 36.8% reported having never taken these medications, compared with 21.2% of persons with health insurance. Adjusted odds ratio (95% CI) of using these drugs in prior 12 months among the uninsured ( compared with insured persons) was 0.28 (0.08, 0.95). Just over 16% of persons with public health plans reported that their insurer initially denied coverage for MS medication. When asked about MS medications in general, 22.3% reported having not filled prescriptions, skipping doses or splitting pills because of cost concerns; 22.4% worried 'a lot' about getting MS medications when they needed them. Substantial fractions of persons with MS confront financial and health plan-related barriers to obtaining MS drugs.