Medicare Costs For Johnson & Johnson's Psoriasis Drug Stelara Double When Obtained at Pharmacies
Medicare Costs For Johnson & Johnson's Psoriasis Drug Stelara Double When Obtained at Pharmacies
Medicare and its beneficiaries are paying significantly more for Stelara, Johnson & Johnson's (NYSE:JNJ) popular biologic drug used to treat autoimmune diseases when obtained through pharmacies rather than administered in physician offices.
醫療保險及其受益人通過藥店獲得強生公司(NYSE:紐交所 JNJ)的受歡迎生物學藥物Stelara治療自身免疫性疾病時，支付的費用顯著高於在醫生辦公室施用時。
Stelara is approved for treating psoriasis, psoriatic arthritis, Crohn's disease, and ulcerative colitis.
Stelara獲准用於治療牛皮癬、銀屑病性關節炎、克羅恩病和潰瘍性結腸炎。
According to a recent analysis by the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS), this price discrepancy is primarily due to differing payment determination methods.
根據衛生和人類服務部( HHS )檢察長辦公室( OIG )最近的分析，這種價格差距主要是由於不同的支付確定方法。
Subcutaneous (under-the-skin) versions of Stelara are typically self-injected and covered under Medicare Part D.
Stelara皮下注射劑通常是自我注射的，並被納入了醫療保險 D 部分。
Before 2023, Part B also covered subcutaneous versions of Stelara when a physician administered the injection; however, Medicare Administrative Contractors (MACs) now exclude Stelara injections under a policy designed to omit self-administered drugs from Part B coverage.
在2023年之前，B部分也涵蓋了Stelara的皮下注射劑，當醫生施用注射時；然而，現在醫療保險管理承包商(MACs)將Stelara注射劑排除在B部分規定的自我管理藥物的範圍之外。
Medicare and its enrollees incurred significantly higher costs when Stelara injections were covered under Part D, where patients self-administer the drug, compared to when the injections were administered by a physician and covered under Part B.
在醫療保險 D 部分，Stelara注射劑得到了覆蓋，患者自我管理藥物，與在醫生處施用並在B部分覆蓋下的注射劑相比，醫療保險及其受益人產生了顯著更高的費用。
Due to recent coverage changes, enrollees who previously received Stelara injections in their doctors' offices under Part B must now obtain the medication through a pharmacy under Part D, which could lead to significantly higher out-of-pocket costs.
由於最近的覆蓋變更，先前在B部分在醫生辦公室接受Stelara注射劑的被保險人現在必須通過藥店在D部分獲得藥物，這可能導致顯著更高的個人費用。
The OIG report highlighted that over the past several years, Medicare expenditures for Stelara have increased almost tenfold, from $300 million in 2016 to almost $3 billion in 2023.
OIG的報告強調，近幾年來，Stelara的醫療保險支出增長了近十倍，從2016年的三千萬美元增加到2023年的近三億美元。
The report adds that from 2016 through 2021, the average Part B cost of Stelara (based on manufacturer-submitted sales data) remained relatively steady, fluctuating between approximately $14,400 and $15,500 for a typical 90 mg injection.
報告還指出，在2016年至2021年期間，Stelara的B部分平均費用(根據製造商提交的銷售數據)保持相對穩定，一個典型的90毫克注射波動在約14400美元和15500美元之間。
During that same period, the average Part D cost (based on negotiations between Part D plans, pharmacy benefit managers, manufacturers, and pharmacies) for a single Stelara injection continually increased, rising from $17,700 to $25,900.
在同一時期，一次 Stelara注射劑的平均D部分成本(基於D部分計劃、藥品效益管理者、製造商和藥店之間的協商)不斷增加，從17700美元上漲到25900美元。
As a result, in 2021, Medicare paid 80% more, on average, for the same drug used to treat the same conditions when it was obtained under Part D (i.e., through a pharmacy) instead of Part B (i.e., administered in a physician's office).
因此，在2021年，醫療保險在D部分(即通過藥店獲得)獲取相同藥物用於治療同樣疾病時，平均支付更多的80%，而不是在B部分(即在醫生辦公室施用)時。
Furthermore, depending on the condition being treated, patients require four to six maintenance doses of Stelara each year. These higher per-injection costs caused Medicare to pay tens of thousands of dollars in additional annual costs for every enrollee who received Stelara under Part D.
此外，根據所治療的疾病不同，患者每年需要進行四到六次的Stelara維持治療。這些較高的每次注射費用導致醫療保險爲每個在D部分接受 Stelara 的被保險人支付成千上萬美元的額外費用。
The substantial cost increase is primarily attributed to the Medicare Part D program, which allows beneficiaries to obtain their medications through pharmacies.
巨大的費用增長主要歸因於醫療保險D部分計劃，該計劃允許受益人通過藥店獲得他們的藥物。
Price Action: JNJ stock is down 0.64% at $159.60 at the last check on Monday.
價格行情：據週一最後查詢，JNJ股票下跌了0.64%，報159.60美元。
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圖片來自shutterstock。
譯文內容由第三人軟體翻譯。