PDF(Pubmed)
Abstract：
BACKGROUND: Despite advances in atopic dermatitis (AD) treatments, many patients face challenges obtaining medications. This study aimed to determine the frequency and causes of insurance coverage delays and denials for AD prescriptions and characterize the associated wait times and extent to which patients understand what to do when faced with a coverage issue.
METHODS: This was a cross-sectional, observational study in which adult U.S. residents (aged 18+ years) with AD or caregivers of pediatric U.S. patients with AD (aged 0-17 years) completed an online survey (3 June-16 July 2021).
RESULTS: Respondents (N = 978) were primarily adults with AD (81.8%), female (67.7%), and white (70.2%). There were 645 insurance delays or denials for AD prescriptions, with 48.1% (470/978) of respondents experiencing at least one delay/denial in the past year. Most delays/denials were for topical steroids (39.2%, 253/645), the most highly used prescription treatment class (83.9%, 821/978). However, the highest rate of delay/denials was for biologics, of which 43.6% (109/250) of all prescriptions faced a delay or denial. Denials were caused primarily by step therapy (27.6%) and delays by prior authorization (55.1%). Only 56.0% of respondents said they would know what to do if they faced an issue with AD prescription coverage.
CONCLUSIONS: Patients with AD frequently experience insurance-related barriers to obtaining recommended therapies, and many do not know how to respond when these barriers arise. Strategies to improve timely therapeutic access are needed.
METHODS: This was a cross-sectional, observational study in which adult U.S. residents (aged 18+ years) with AD or caregivers of pediatric U.S. patients with AD (aged 0-17 years) completed an online survey (3 June-16 July 2021).
RESULTS: Respondents (N = 978) were primarily adults with AD (81.8%), female (67.7%), and white (70.2%). There were 645 insurance delays or denials for AD prescriptions, with 48.1% (470/978) of respondents experiencing at least one delay/denial in the past year. Most delays/denials were for topical steroids (39.2%, 253/645), the most highly used prescription treatment class (83.9%, 821/978). However, the highest rate of delay/denials was for biologics, of which 43.6% (109/250) of all prescriptions faced a delay or denial. Denials were caused primarily by step therapy (27.6%) and delays by prior authorization (55.1%). Only 56.0% of respondents said they would know what to do if they faced an issue with AD prescription coverage.
CONCLUSIONS: Patients with AD frequently experience insurance-related barriers to obtaining recommended therapies, and many do not know how to respond when these barriers arise. Strategies to improve timely therapeutic access are needed.
摘要：
背景：尽管特应性皮炎（AD）治疗方法取得了进展，许多患者在获得药物治疗方面面临挑战。这项研究旨在确定AD处方的保险承保延迟和拒绝的频率和原因，并描述相关的等待时间和患者在面对承保问题时该怎么做的程度。
方法：这是一个横截面，在观察性研究中,美国成年AD患者(18岁以上)或美国儿科AD患者(0~17岁)的护理人员完成了一项在线调查(2021年6月3日至7月16日).
结果：受访者（N=978）主要是患有AD的成年人（81.8％），女性(67.7%)，白色（70.2%）。有645次AD处方的保险延误或拒绝，48.1%(470/978)的受访者在过去一年中至少经历过一次延迟/拒绝。大多数延误/拒绝是局部类固醇（39.2％，253/645），使用最多的处方治疗类(83.9%，821/978)。然而,延迟/拒绝率最高的是生物制品，其中43.6%(109/250)的处方面临延迟或拒绝。拒绝主要由阶梯治疗（27.6％）和事先授权的延迟（55.1％）引起。只有56.0%的受访者表示，如果他们面临AD处方保险的问题，他们会知道该怎么做。
结论：AD患者在获得推荐治疗时经常会遇到保险相关障碍，当这些障碍出现时，许多人不知道如何应对。需要改进及时获得治疗的策略。
方法：这是一个横截面，在观察性研究中,美国成年AD患者(18岁以上)或美国儿科AD患者(0~17岁)的护理人员完成了一项在线调查(2021年6月3日至7月16日).
结果：受访者（N=978）主要是患有AD的成年人（81.8％），女性(67.7%)，白色（70.2%）。有645次AD处方的保险延误或拒绝，48.1%(470/978)的受访者在过去一年中至少经历过一次延迟/拒绝。大多数延误/拒绝是局部类固醇（39.2％，253/645），使用最多的处方治疗类(83.9%，821/978)。然而,延迟/拒绝率最高的是生物制品，其中43.6%(109/250)的处方面临延迟或拒绝。拒绝主要由阶梯治疗（27.6％）和事先授权的延迟（55.1％）引起。只有56.0%的受访者表示，如果他们面临AD处方保险的问题，他们会知道该怎么做。
结论：AD患者在获得推荐治疗时经常会遇到保险相关障碍，当这些障碍出现时，许多人不知道如何应对。需要改进及时获得治疗的策略。
