医疗补助计划和医疗保险计划患者的γ-羟丁酸(GHB)处方量增加,但地区差异明显

Josephine Barnhart, Sondra Vujovich, Brian Piper
{"title":"医疗补助计划和医疗保险计划患者的γ-羟丁酸(GHB)处方量增加,但地区差异明显","authors":"Josephine Barnhart, Sondra Vujovich, Brian Piper","doi":"10.1101/2024.02.20.24303095","DOIUrl":null,"url":null,"abstract":"Background Gamma hydroxybutyrate (GHB) is a Schedule III drug in the US approved for treatment of cataplexy associated with narcolepsy. Narcolepsy with cateplaxy is a rare disorder with an annual incidence of less than one per one hundred thousand and GHB is a third line treatment. The purpose of this study was to describe the temporal pattern of GHB distribution and cost nationally and between states for Medicaid and Medicare patients. Methods GHB prescriptions were extracted from the State Utilization Data Tool from Medicaid.gov and the Medicare part D Prescribers by Provider and Drug Dataset from CMS.gov. GHB prescriptions were examined by state when corrected for population. States outside a 95 percent confidence interval were considered statistically significant. GHB cost analyses were performed between 2017−2021. GHB prescribers were identified for Medicare in 2019. Results There was a steady increase in prescriptions (±88.5 percent) from 2019 to 2021 and spending (±39.6 percent) from 2017 to 2020 for Medicaid. Specialists other than somnologists, were found to prescribe the highest number of GHB prescriptions to Medicare Part D enrollees. In 2019, two states (Hawaii and North Dakota) did not prescribe GHB to Medicare patients versus twenty states for Medicaid patients. Marylands prescribing to Medicare patients was significantly elevated (269.2 per 100K). Conclusion GHB prescribing has increased to Medicaid and Medicare patients. Further research is necessary to understand how the COVID19 pandemic and off label prescribing (e.g. for excessive daytime sleepiness) may have affected these findings including the origins of the pronounced state level disparities.","PeriodicalId":501072,"journal":{"name":"medRxiv - Health Economics","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Increase but pronounced regional disparities in gamma-hydroxybutyrate (GHB) prescriptions among Medicaid and Medicare patients\",\"authors\":\"Josephine Barnhart, Sondra Vujovich, Brian Piper\",\"doi\":\"10.1101/2024.02.20.24303095\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background Gamma hydroxybutyrate (GHB) is a Schedule III drug in the US approved for treatment of cataplexy associated with narcolepsy. Narcolepsy with cateplaxy is a rare disorder with an annual incidence of less than one per one hundred thousand and GHB is a third line treatment. The purpose of this study was to describe the temporal pattern of GHB distribution and cost nationally and between states for Medicaid and Medicare patients. Methods GHB prescriptions were extracted from the State Utilization Data Tool from Medicaid.gov and the Medicare part D Prescribers by Provider and Drug Dataset from CMS.gov. GHB prescriptions were examined by state when corrected for population. States outside a 95 percent confidence interval were considered statistically significant. GHB cost analyses were performed between 2017−2021. GHB prescribers were identified for Medicare in 2019. Results There was a steady increase in prescriptions (±88.5 percent) from 2019 to 2021 and spending (±39.6 percent) from 2017 to 2020 for Medicaid. Specialists other than somnologists, were found to prescribe the highest number of GHB prescriptions to Medicare Part D enrollees. In 2019, two states (Hawaii and North Dakota) did not prescribe GHB to Medicare patients versus twenty states for Medicaid patients. Marylands prescribing to Medicare patients was significantly elevated (269.2 per 100K). Conclusion GHB prescribing has increased to Medicaid and Medicare patients. Further research is necessary to understand how the COVID19 pandemic and off label prescribing (e.g. for excessive daytime sleepiness) may have affected these findings including the origins of the pronounced state level disparities.\",\"PeriodicalId\":501072,\"journal\":{\"name\":\"medRxiv - Health Economics\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-02-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"medRxiv - Health Economics\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1101/2024.02.20.24303095\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"medRxiv - Health Economics","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1101/2024.02.20.24303095","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

背景 γ-羟丁酸(GHB)是美国批准的第三类药物,用于治疗与嗜睡症相关的紧张性失神。伴有卡他性瘫痪的嗜睡症是一种罕见疾病,年发病率不到十万分之一,而 GHB 是一种三线治疗药物。本研究旨在描述 GHB 在全国以及各州医疗补助和医疗保险患者中的分布和费用的时间模式。方法 GHB 处方提取自 Medicaid.gov 的 "州使用数据工具 "和 CMS.gov 的 "医疗保险 D 部分处方者(按提供者和药物)数据集"。经人口校正后,按州对 GHB 处方进行了检查。置信区间在 95% 以外的州被视为具有统计学意义。GHB 成本分析在 2017-2021 年间进行。GHB 处方者于 2019 年被确定为医疗保险的处方者。结果 2019 年至 2021 年的处方量(±88.5%)和 2017 年至 2020 年的医疗补助支出(±39.6%)稳步增长。研究发现,除体液学家外,其他专科医生为医疗保险 D 部分参保者开出的 GHB 处方数量最多。2019 年,有两个州(夏威夷州和北达科他州)没有为医疗保险患者开具 GHB 处方,而为医疗补助患者开具 GHB 处方的州则有 20 个。马里兰州向医疗保险患者开具的处方明显增加(每 10 万人 269.2 个)。结论 向医疗补助和医疗保险患者开具 GHB 的情况有所增加。有必要开展进一步研究,以了解 COVID19 大流行和标签外处方(如用于白天过度嗜睡)如何影响这些发现,包括各州之间存在明显差异的原因。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Increase but pronounced regional disparities in gamma-hydroxybutyrate (GHB) prescriptions among Medicaid and Medicare patients
Background Gamma hydroxybutyrate (GHB) is a Schedule III drug in the US approved for treatment of cataplexy associated with narcolepsy. Narcolepsy with cateplaxy is a rare disorder with an annual incidence of less than one per one hundred thousand and GHB is a third line treatment. The purpose of this study was to describe the temporal pattern of GHB distribution and cost nationally and between states for Medicaid and Medicare patients. Methods GHB prescriptions were extracted from the State Utilization Data Tool from Medicaid.gov and the Medicare part D Prescribers by Provider and Drug Dataset from CMS.gov. GHB prescriptions were examined by state when corrected for population. States outside a 95 percent confidence interval were considered statistically significant. GHB cost analyses were performed between 2017−2021. GHB prescribers were identified for Medicare in 2019. Results There was a steady increase in prescriptions (±88.5 percent) from 2019 to 2021 and spending (±39.6 percent) from 2017 to 2020 for Medicaid. Specialists other than somnologists, were found to prescribe the highest number of GHB prescriptions to Medicare Part D enrollees. In 2019, two states (Hawaii and North Dakota) did not prescribe GHB to Medicare patients versus twenty states for Medicaid patients. Marylands prescribing to Medicare patients was significantly elevated (269.2 per 100K). Conclusion GHB prescribing has increased to Medicaid and Medicare patients. Further research is necessary to understand how the COVID19 pandemic and off label prescribing (e.g. for excessive daytime sleepiness) may have affected these findings including the origins of the pronounced state level disparities.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信