背景:高昂的自付处方药成本会导致财务毒性,药物不依从性,和不良心血管(CV)结局。决策者最近通过了《降低通货膨胀法》,这将把医疗保险自付药物成本限制在2000美元/年,并扩大全额低收入补贴(LIS)。尚不清楚这些规定将如何影响具有CV风险因素和/或条件的Medicare受益人。
目的:作者试图表征具有CV风险因素/条件的Medicare受益人人群的自付处方药成本>2,000美元/年,并根据《通货膨胀减少法案》的支出上限估算他们的潜在节省;确定与自付成本>2,000美元/年相关的社会人口统计学特征;并根据《通货膨胀减少法案》表征新获得LIS资格的受益人。
方法:这是一项针对2016年至2019年年龄≥65岁且具有≥1个CV风险因素/状况的Medicare受益人的横断面研究。
结果:每年估计有34,056,335±855,653名医疗保险受益人(平均值±SE)具有≥1个CV风险因素/状况,其中1,020,484±77,055人的自付药费>2,000美元/年。在≥75岁的成年人中,经历自付药物费用>2,000美元/年的可能性较低(调整后的OR:0.67;95%CI:0.49-0.93),低收入和高收入成年人。在受益人中,目前的支出>2,000美元/年,根据《降低通货膨胀法》,估计自费药物节省的中位数为855美元/年,年度总节省为1,723,031,307美元±91,150,609美元。估计有1,289,861名受益人也将有新的资格获得LIS。
结论:超过100万患有心血管危险因素和/或疾病的老年人每年在处方药上花费>2,000美元,可能会从《降低通货膨胀法》的上限中受益,估计每年的自付储蓄总额为17亿美元,而另外130万也将有资格获得LIS。
High out-of-pocket prescription drug costs contribute to financial toxicity, medication nonadherence, and adverse cardiovascular (CV) outcomes. Policymakers recently passed the Inflation Reduction Act, which will cap Medicare out-of-pocket drug costs at $2,000/year and expand full low-income subsidies (LIS). It is unclear how these provisions will affect Medicare beneficiaries with CV risk factors and/or conditions.
The authors sought to characterize the population of Medicare beneficiaries with CV risk factors/conditions experiencing out-of-pocket prescription drug costs >$2,000/year and estimate their potential savings under the Inflation Reduction Act\'s spending cap; identify sociodemographic characteristics associated with out-of-pocket costs >$2,000/year; and characterize beneficiaries newly eligible for LIS under the Inflation Reduction Act.
This was a cross-sectional study of Medicare beneficiaries aged ≥65 years with ≥1 CV risk factor/condition from 2016 to 2019.
An annual estimated 34,056,335 ± 855,653 Medicare beneficiaries (mean ± SE) had ≥1 CV risk factor/condition, of whom 1,020,484 ± 77,055 experienced out-of-pocket drug costs >$2,000/year. The likelihood of experiencing out-of-pocket drug costs >$2,000/year was lower among adults ≥75 years vs 65 to 74 years (adjusted OR: 0.67; 95% CI: 0.49-0.93) and for low-income vs higher-income adults. Among beneficiaries currently spending >$2,000/year, estimated median out-of-pocket drug savings would be $855/year and total annual savings $1,723,031,307 ± $91,150,609 under the Inflation Reduction Act. An estimated 1,289,861 beneficiaries would also become newly eligible for LIS.
More than 1 million older adults with CV risk factors and/or conditions spend >$2,000/year out-of-pocket on prescription drugs and will likely benefit from the Inflation Reduction Act\'s cap, with estimated total out-of-pocket savings of $1.7 billion/year, while another 1.3 million will also become newly eligible for LIS.