机构：[1]Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China[2]School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China[3]Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China[4]Department of Hematology, Beijing Children’s Hospital, Capital Medical University, Beijing, China医技科室血液中心首都医科大学附属北京儿童医院[5]Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China[6]Shandong Center of Hemophilia Diagnosis and Treatment, Jinan, China[7]Department of Hematology, Dalian Municipal Central Hospital, Dalian Medical University, Dalian, China[8]Department of Pediatric Hematology, Tongji Hospital, Tongji Medical College Huazhong, University of Science & Technology, Wuhan, China内科系统血液内科华中科技大学同济医学院附属同济医院[9]Department of Pediatric Hematology and Oncology, Chengdu Women and Children’s Center Hospital, Chengdu, China[10]Department of Hematology, Subei people’s Hospital, Yangzhou, China苏北人民医院[11]Department of Hematology, Drum Tower Hospital, Nanjing University Medical School, Nanjing, China[12]Department of Hematology, NanFang Hospital, Southern Medical University, Guangzhou, China[13]Department of Hematology and Oncology, Shenzhen Children’s Hospital, Shenzhen, China[14]Department of Hematology, Children’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China[15]Division of Hematology/Hematologic Malignancies, Department of Medicine, University of Calgary-Foothills Hospital, Southern Alberta Rare Blood and Bleeding Disorders Comprehensive Care Program, Calgary, Canada
ObjectiveTo explore the influence of medical insurance policy and charity assistance projects on the uptake and discontinuation of regular prophylaxis treatment in Chinese severe haemophilia A children. MethodologyThis retrospective study was conducted on children with severe haemophilia A, who received FVIII prophylaxis treatment at 12 haemophilia centres in China from 1 November 2007 to 31 May 2013. ResultsThe average duration of prophylaxis treatment received by haemophilia children significantly increased from 16.7weeks in 2008 to 32.8weeks in 2012 (P<.001). The main reason for prophylaxis acceptance included dissatisfaction with previous on-demand regimens, availability of improved local medical insurance policies and patient/family awareness of haemophilia. The main reason for subsequent discontinuation of prophylaxis was economic instability. The upper limit of insurance was up to RMB 150000/y (USD: 22000/y) for 80.1% of the insured patients and would be sufficient to cover the continuous low-dose prophylaxis regimen. However, for many patients the burden of out-of-pocket copayment cost represented a risk for poor adherence to regular prophylaxis. In about two third of the patients, the annual out-of-pocket copayment cost amounted to >50% of their average annual disposable income. Many patients therefore required assistance from the charity assistance projects, but nonadherence remained prevalent. ConclusionMedical insurance policy and charity assistance projects helped haemophilia children to accept and continue prophylaxis regimens. It was the proportion of the out-of-pocket copayment cost rather than the upper limit of insurance reimbursement that restricted long-term regular low-dose prophylaxis in China.
基金：
Bayer Healthcare Co. Ltd., China; CAMS Central Public Welfare Scientific Research [2017PT31004]
第一作者机构：[1]Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
共同第一作者：
通讯作者：
通讯机构：[1]Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China[*1]Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China.
推荐引用方式(GB/T 7714)：
Z. Li,J. Wu,Y. Zhao,et al.Influence of medical insurance schemes and charity assistance projects on regular prophylaxis treatment of the boys with severe haemophilia A in China[J].HAEMOPHILIA.2018,24(1):126-133.doi:10.1111/hae.13372.
APA：
Z. Li,J. Wu,Y. Zhao,R. Liu,K. Li...&J. Xiao.(2018).Influence of medical insurance schemes and charity assistance projects on regular prophylaxis treatment of the boys with severe haemophilia A in China.HAEMOPHILIA,24,(1)
MLA：
Z. Li,et al."Influence of medical insurance schemes and charity assistance projects on regular prophylaxis treatment of the boys with severe haemophilia A in China".HAEMOPHILIA 24..1(2018):126-133
