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NEW ORLÉE – Increasingly aggressive insurance strategies have reduced the total costs and insurance costs of growth hormone medications, but these savings are not being pbaded on to patients, according to a new report. study presented Sunday at ENDO 2019, the annual meeting of the Endocrine Society in New Orleans, La.
In 2003, the US Food and Drug Administration approved growth hormone treatment for idiopathic small sizes (small children with no known cause). This has increased the potential eligibility for treatment by up to 1.2% of the US population, with a potential national cost estimated at $ 40 billion.
"However, in the following years, health insurance companies imposed greater barriers to reimbursement for growth hormone treatment," said lead researcher Adda Grimberg, MD, of the Perelman School of Medicine and from the Leonard Davis Institute of Health Economics at the University of Pennsylvania in Philadelphia, Pennsylvania. . Insurers have put in place forms – lists of drugs covered by the insurance plan – that exclude almost all brands of growth hormone-based drugs, and frequently modify them based on prices negotiated with manufacturers, forcing patients to change brands during their journey. treatment. Insurers have also adopted stricter coverage criteria and many of them no longer cover growth hormone treatment for idiopathic small cases.
Grimberg and her co-author, Genevieve P. Kanter, Ph.D., of the University of Pennsylvania, examined the evolution of growth hormone use by young Americans. With the help of a database of 18 million individuals enrolled in commercial health plans, they examined the evolution of use and expenditures between 2001 and 2001. 2016. They targeted the 38,857 recipients under 18 years of age treated with growth hormone and benefiting from an insurance coverage of six months or more. year between 2001 and 2016.
The number of members with growth hormone prescriptions per 10,000 beneficiaries under the age of 18 has increased steadily, from 5.1 in 2001 to 14.6 in 2016, with no dramatic change around 2003, year the FDA approved coverage for idiopathic small size. The progressive restrictions of growth hormone coverage imposed by insurers and the stricter rules of the form appear to have been successful in lowering the total cost and the cost of treatment for insurers. However, these savings were not pbaded on to patients, who were also forced to change their brand of drugs as insurance companies changed their forms.
While total growth hormone expenditure per patient decreased by 27% and the estimated amount of insurance paid decreased by 28%, average payments, deductibles and total patient financial burden increased by 161%. Between 2001 and 2007, beneficiaries who switched growth hormone brands at least once a year ranged from 1.4% to 3.6%. After 2007, the range went from 5.1% to 8.8%, with 25.6% in 2009 and 13.9% in 2015.
"These patterns are consistent with broader trends in the United States of increasing patient cost-sharing, aggressive use of forms, and coverage restrictions to limit insurers' costs due to high drug prices." specialty, "said Grimberg. "The increase in the cost of insulin for patients has become a major concern for health care in recent days, resulting in congressional hearings and a review of legislation." "Growth hormone, another endocrine drug such as insulin, costs more to patients, even as insurers have declined."
Grimberg noted that patients' burden for growth hormone brand changes and refusals / insurance claims is a source of great distress for families of patients in search of badessment and small treatment cut. "Since different brands of growth hormones are distributed in different pens, brand changes imposed by insurance over the years of a patient's treatment with growth hormone require new training on good administration, so the process is more complicated than moving from one pill to another, "she says.
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Endocrinologists are at the heart of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health and hormone-related cancers. The Endocrine Society is the world's oldest and largest organization of scientists dedicated to hormone research and doctors who treat people with hormone-related disorders.
The Society has more than 18,000 members, including scientists, doctors, educators, nurses and students from 122 countries. To find out more about the Company and the field of endocrinology, visit our website at http://www.nrc.gov.on.ca.
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