一剂管理式医疗：控制医疗补助计划中的药品支出

中文摘要

我们研究医疗补助药品福利私有化对药品价格和药品使用的影响。如果由私人保险公司管理所有药品福利，药品支出将下降 21.3%。其中三分之一的下降源于私人保险公司与药店议价的能力。其余三分之二源于更多地使用低成本药品（如仿制药），且仅在那些给予私人保险公司设计药品福利灵活性的州才能实现。私有化并未减少每名参保人的处方数量，且对于能降低医疗支出的药品，支出削减幅度更小。

Abstract

We study the effect of privatizing Medicaid drug benefits on drug prices and utilization. Drug spending would decrease by 21.3 percent if private insurers administered all drug benefits. One-third of the decrease is driven by private insurers’ ability to negotiate prices with pharmacies. The remaining two-thirds is driven by the greater use of lower cost drugs, such as generics, and is only realized in states that give private insurers the flexibility to design drug benefits. Privatization does not reduce prescriptions per enrollee and spending cuts are smaller for drugs that lower medical spending.