PO.SHP01.01 · 科学与健康政策
事先授权政策改革对乳腺癌治疗的影响
The impacts of prior authorization policy reforms on breast cancer treatment
作者与单位 Authors & Affiliations
摘要 Abstract
中文摘要
事先授权（PA）是一种广泛使用的成本控制工具，要求由第三方批准才能覆盖医学检测和治疗。这一流程对医生而言耗时较长，且常与患者治疗延误相关；在癌症治疗中，近80%的口服化疗药需要PA，且大多数接受PA的癌症患者报告延误达两周或以上。事先授权的负担日益受到关注，近期州和联邦政策的重大变化旨在简化和加快PA。然而，这些政策对癌症治疗的影响仍不明确。我们利用Oncoshare数据库（2012-2020年）的数据，采用准实验设计评估两项加州法律（SB 866和SB 282，分别于2012年和2014年通过）如何影响乳腺癌患者的药物使用和治疗时间。虽然我们未观察到药物使用的显著变化，但两项法律均与治疗时间的缩短相关。这些发现提示PA改革改善了癌症治疗的及时可及性。
查看英文原文 English abstract
Prior authorization (PA) is a widely used cost-containment tool that requires third-party approval for coverage of medical tests and treatments. This process is time-intensive for physicians and is frequently associated with delays in patient care; in cancer care, almost 80% of oral chemotherapies require PA, and most cancer patients undergoing PA report delays of two or more weeks. The burden of prior authorization is a growing concern, and major recent changes in state and federal policy aim to streamline and expedite PA. However, the impact of these policies on cancer care remains unclear. Using data from the Oncoshare database (2012-2020), we evaluate how two California laws (SB 866 and SB 282, passed in 2012 and 2014) affect medication utilization and time to treatment among breast cancer patients using a quasi-experimental design. While we observed no significant changes in medication utilization, both laws were associated with reductions in time to treatment. These findings suggest that PA reform improves timely access to cancer therapies.
利益披露 Disclosure
M. E. Hutchins, None..
A. Adams, None..
L. Ma, None..
A. Kurian, None..
M. Satoyshi, None.