分析《安全阶梯法案》对患者、医生和保险公司的益处和成本

Divya M. Shan, Jonathan D. Greenzaid, Estay Greene, S. Feldman
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引用次数: 0

摘要

在昂贵的外用药和生物制剂治疗的推动下,美国的医药支出,尤其是皮肤科的医药支出增长迅速。保险公司正在采用阶梯疗法等控制成本的策略,规定在使用较昂贵的药物之前先使用成本较低的治疗方法。两党共同提出的《安全阶梯法案》旨在通过引入透明的例外申请流程和合理的流程时限来加强阶梯疗法政策。然而,关于《安全阶梯法案》将如何影响医疗环境的分析却十分有限。我们研究了《安全阶梯法案》的政策和现有关于预先授权的文献,并讨论了该法案会对患者、医生和保险公司产生怎样的影响。虽然该法案可以加快患者获得必要药物的速度,并防止因延误有效治疗而对患者造成不可逆转的伤害,但在减轻皮肤科诊所的管理负担方面还存在不足。虽然没有管理医疗成本的理想解决方案,但阶梯疗法等措施鼓励了具有成本效益的治疗,并优化了对人群的护理。通过《安全阶梯法案》的豁免程序限制阶梯疗法可能会简化患者获得治疗的途径,但可能会阻碍成本控制策略,削弱保险公司的议价能力,导致保险费上涨。
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Analyzing the Benefits and Costs of the Safe Step Act on Patients, Physicians, and Insurers
Pharmaceutical expenditures in the United States, particularly in dermatology, have grown rapidly, driven by expensive topical and biologic treatments. Insurers are employing cost-containing strategies such as step therapy, which mandates the use of lower-cost treatments before more expensive medications. The bipartisan Safe Step Act aims to enhance step therapy policies by introducing a transparent process for requesting exceptions and reasonable timelines for the process. However, there is limited analysis on how the Safe Step Act would affect the healthcare environment. We examine the policies of the Safe Step Act and existing literature on prior authorizations and discuss how the bill could affect patients, physicians, and insurers. While the act could expedite access to necessary medications and prevent irreversible harm to patients from delaying efficacious treatment, it falls short in relieving the administrative burdens on dermatology clinics. Although there is no ideal solution for managing healthcare costs, measures like step therapy encourage cost-effective treatments and optimizing care for the population. Curtailing step therapy with the exemptions process of the Safe Step Act might streamline patient access to treatments but could impede cost-containment strategies, weaken the bargaining power of insurers, and result in higher insurance premiums.
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来源期刊
CiteScore
1.30
自引率
0.00%
发文量
19
期刊最新文献
2024 Reviewer Thank You. Management of Chronic Generalized Pustular Psoriasis: A Review and Expert Opinion. Healthcare Resource Utilization Among Patients With Generalized Pustular Psoriasis: The Impact of Flares and Disease Severity. Criteria for Identifying Candidates for Systemic Psoriasis Treatment in the Real World: Application of the International Psoriasis Council Guidelines in Patients in North America. The FORWARD Psoriasis Registry: Patient-Reported Outcomes in a Novel Psoriasis Registry and Comparison of Traditional, Dermatologist-Led Enrollment With Web-Based Patient Enrollment.
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