Background: We conducted a study to investigate the role of health insurance plans on biosimilar adoption among commercially insured patients in the USA. Flexible and rigid health plans may exhibit differing biosimilar coverage due to variations in cost considerations, formulary design, and provider networks.
Objective: To identify the characteristics of switchers and biosimilar initiators for six biologic-biosimilar pairs.
Methods: Using claims data from 2015 to 2019, we implement sequential regression models to assess the role of health plans on biosimilars adoption.
Findings: We found that low-flexibility plans, such as Health Maintenance Organization (HMOs) and Exclusive Provider Organization (EPOs), are more likely to have patients who are switchers and/or biosimilar initiators.
Conclusion: Our findings highlight the importance of health insurance plan design in promoting biosimilar uptake.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10781919 | PMC |
http://dx.doi.org/10.1007/s41669-023-00447-6 | DOI Listing |
BMC Health Serv Res
January 2025
School of Humanities and Social Sciences, Beihang University, No. 37 Xueyuan Road, Beijing, 100191, China.
Background: To address the health inequity caused by decentralized management, China has introduced a provincial pooling system for urban employees' basic medical insurance. This paper proposes a research framework to evaluate similar policies in different contexts. This paper adopts a mixed-methods approach to more comprehensively and precisely capture the causal effects of the policy.
View Article and Find Full Text PDFBMC Public Health
January 2025
Research Institute for Healthcare Policy, Korean Medical Association, Yongsan-gu, Seoul, South Korea.
Background: In 2024, the Korean Ministry of Health and Welfare enforced a policy to increase the number of medical school students by 2,000 over the next 5 years, despite opposition from doctors. This study aims to predict the trend of excess or shortage of medical personnel in Korea due to the policy of increasing the number of medical school students by 2035.
Methods: Data from multiple sources, including the Ministry of Health and Welfare, National Health Insurance Corporation, and the Korean Medical Association, were used to estimate supply and demand.
BMC Health Serv Res
January 2025
Department of Health Policy and Management, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Background: Family physician program is one of the effective reforms of the health system in Iran, but despite the implementation of this program in rural areas and the passage of ten years since its implementation in two provinces of Fars and Mazandaran, its implementation has faced problems. The aim of this study is to identify and prioritize implementation solutions related to the challenges of the family physician program in Iran.
Methods: This is a qualitative study using semi-structured interviews with 22 snowball-sampled experts and managers of basic health insurers to extract problems and executive solutions through coding and data analysis using Atlas Ti software and content analysis in the first stage.
Pituitary
January 2025
Department of Neurological Surgery, University of Miami Miller School of Medicine, 1095 NW 14th Terrace, 2nd Floor, Miami, Fl, 33136, USA.
Purpose: Prolonged length of stay (PLOS) can lead to resource misallocation and higher complication risks. However, there is no consensus on defining PLOS for endoscopic transsphenoidal pituitary surgery (ETPS). Therefore, we investigated the impact of varying PLOS definitions on factors associated with PLOS in patients undergoing ETPS.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, 04763, Republic of Korea.
To evaluate the incidence and risk of cardiovascular disease (CVD) among Korean patients with systemic lupus erythematosus (SLE) comparing them to diabetes patients and the general population. This nationwide cohort study focused on incident SLE patients aged over 40 years, matched with diabetes patients and the general population (1:4:4 ratio). CVD was defined as ischaemic heart disease, ischaemic stroke, and cardiac arrest.
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