Insurance coverage

Impact of public health insurance coverage of new cancer drugs on medical expenditure and patient affordability in a provincial medical center in China: a propensity score matching analysis with the quasi-experimental design

This article was originally published here

BMJ open. 2022 Feb 16;12(2):e054713. doi: 10.1136/bmjopen-2021-054713.


INTRODUCTION: Little is known about the impact of government efforts to have new cancer drugs covered by the public health insurance system in China. This study targeting the above policy implemented in Fujian province in 2017, analyzed the impact of the policy on the medical expenditure of cancer treatment and patient affordability based on clinical data from the medical center from Fujian province.

METHODS: The study included 253 breast cancer patients positive for human epidermal growth factor receptor 2 who had completed at least one course of trastuzumab retrieved from the Center’s Hospital Health Information System Fujian Provincial Medical. We adopted the propensity score matching method to mimic a quasi-experimental design to estimate the impact of public health insurance coverage policy on all indicated patients with a before-after comparison of total medical expenditure. direct diseases associated with breast cancer for a standard. course of treatment or maintenance treatment and proportional out-of-pocket patient expenses based on actual clinical data.

RESULTS: We found evidence of an association between public health insurance coverage of new breast cancer drugs and medical expenditure reductions of US$18,661.02 (95% CI 13,836.57 at 28,201.45), and proportional out-of-pocket expenditure of 24% (95% CI 0.20 to 0.27). The medical expenses and the proportional expenses of the patients borne by the patient could be generally reduced.

CONCLUSIONS: Public health insurance coverage of innovative breast cancer drugs was found to be associated with reduced medical expenditure and OOP patient expenditure share for cancer treatment of indicated patients. Patients with low ability to pay did not benefit well from the coverage policy. To maximize the welfare of public health insurance coverage for new cancer drugs, the study called for strengthening the health insurance benefit packages of the rural patient and the patient enrolled in the program. health insurance for urban and rural residents, who might have a lower ability to pay and need more support from the public safety system.

PMID:35173004 | DO I:10.1136/bmjopen-2021-054713