{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T05:28:05Z","timestamp":1793251685043,"version":"4.5.0"},"reference-count":17,"publisher":"American Medical Association (AMA)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi240449-4\"><jats:title>Importance<\/jats:title><jats:p>Recent changes in China\u2019s social medical insurance reimbursement policy have impacted the financial burden of patients with phenylketonuria (PKU) for special foods. However, whether this policy change is associated with their blood phenylalanine (PHE) concentration is unclear.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240449-5\"><jats:title>Objective<\/jats:title><jats:p>To investigate the association between the reimbursement policy and blood PHE concentration in patients with PKU.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240449-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This cohort study measured the blood PHE concentrations of 167 patients with PKU across 4 newborn screening centers in China from January 2018 to December 2021. The reimbursement policy for special foods for patients with PKU at 2 centers was canceled in 2019 and restored from 2020 onwards. In contrast, the other 2 centers consistently implemented the policy. Data were analyzed from September 10 to December 6, 2023.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240449-7\"><jats:title>Exposures<\/jats:title><jats:p>The implementation and cancelation of the reimbursement policy for special foods of patients with PKU.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240449-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>The blood PHE concentration was regularly measured from 2018 to 2021. A 1-sided <jats:italic>Z<\/jats:italic> test was used to compare the mean of the blood PHE concentration between different years.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240449-9\"><jats:title>Results<\/jats:title><jats:p>Among 167 patients with PKU (mean [SD] age, 84.4 [48.3] months; 87 males [52.1%]), a total of 4285 measurements of their blood PHE concentration were collected from 2018 to 2021. For patients at the center that canceled the reimbursement policy in 2019, the mean (SD) of the blood PHE concentrations in 2019 was 5.95 (5.73) mg\/dL, significantly higher than 4.84 (4.11) mg\/dL in 2018 (<jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001), 5.06 (5.21) mg\/dL in 2020 (<jats:italic>P<\/jats:italic>\u2009=\u2009.006), and 4.77 (4.04) mg\/dL in 2021 (<jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001). Similarly, for patients at the other center that canceled the policy in 2019, the mean (SD) of the blood PHE concentrations in 2019 was 5.95 (3.43) mg\/dL, significantly higher than 5.34 (3.45) mg\/dL in 2018 (<jats:italic>P<\/jats:italic>\u2009=\u2009.03), 5.13 (3.15) mg\/dL in 2020 (<jats:italic>P<\/jats:italic>\u2009=\u2009.003), and 5.39 (3.46) mg\/dL in 2021 (<jats:italic>P<\/jats:italic>\u2009=\u2009.03). On the contrary, no significant difference was observed between any of the years for patients at the 2 centers that consistently implemented the policy.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240449-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>In this cohort study of patients with PKU from multiple centers, the implementation of the reimbursement policy for special foods was associated with controlling the blood PHE concentration. Special foods expenditure for patients with PKU should be included in the scope of long-term social medical insurance reimbursement.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.12886","type":"journal-article","created":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T15:06:50Z","timestamp":1717600010000},"page":"e2412886","source":"Crossref","is-referenced-by-count":7,"title":["Insurance Reimbursement for Special Foods and Phenylalanine Levels in Patients With PKU in China"],"prefix":"10.1001","volume":"7","author":[{"given":"Bo","family":"Wang","sequence":"first","affiliation":[{"name":"College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, Hubei, PR China"},{"name":"Medical Genetics Center, Maternal and Child Health Hospital of Hubei Province, Wuhan, Hubei, PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanzhi","family":"Xia","sequence":"additional","affiliation":[{"name":"College of Life Science and 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