Journal•ISSN: 1590-9158
PharmacoEconomics. Italian research articles
Springer Nature
About: PharmacoEconomics. Italian research articles is an academic journal. The journal publishes majorly in the area(s): Population & Cost effectiveness. It has an ISSN identifier of 1590-9158. Over the lifetime, 193 publications have been published receiving 712 citations.
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TL;DR: The document suggests to extend the EBM approach to economic analysis and details how to do it in practice and adopts the approach of the reference case which sets precise rules about major methodological decisions.
Abstract: This document presents the results of the Italian Health Economics Association (AIES) working group established to suggest guidelines on how to conduct economic evaluation studies of health programs. The document conceptualises such studies as part of health technology assessment carried out to provide guidance to the Italian National Health Service (INHS). The document aims to make available to public institutions, regulatory agencies and organizations operating in the health field a valid and feasible tool to make decisions more rational and more productive in terms of health gains. Overall, evidence-based medicine (EBM) is gaining ground and clinical decisions are increasingly taken on the basis of adequate scientific knowledge. The document suggests to extend the EBM approach to economic analysis and details how to do it in practice. The guidelines adopt the approach of the reference case which sets precise rules about major methodological decisions. Such an approach eases comparisons of results across studies and thus contributes to use them consistently in decision making. The reference case identifies the cost-effectiveness analysis, and in particular the incremental cost per Quality-Adjusted Life-Year (QALY), as the method to be used in the reference case in economic evaluations. The guidelines intend to stimulate the discussion among main actors and stakeholders who want to contribute to the development of rational governing tools for the INHS.
94 citations
TL;DR: The algorithm can prove a useful starting point in determining the price of drugs and can be modified in the future, introducing the evaluation of further parameters in order to reflect the complexity of clinical practice, “real” patients management and possible outcomes.
Abstract: The aim of this article was to present an algorithm that, on the basis of parameters as objective as possible, converts the clinical benefit of an innovative drug into an economic figure that can be helpful in determining the price of the drug. Outcomes considered by the algorithm include prolongation in survival, avoidance of disease-related events, savings in the use of health-care resources; the algorithm is unable to handle quality of life expressed as utility. Each month of survival gained is valued from € 1000 to € 5000; cost-of-illness data are used to convert the avoidance of unfavourable disease-specific events into economic figures; when present, documented savings in direct costs are in part incorporated in the drug price. The algorithm is designed to be used by national regulatory agencies and, in some cases, by hospital pharmacies that produce orphan drugs. Three examples of application of the algorithm are presented, concerning drotrecogin, fondaparinux, and oral fludarabine, respectively. A fourth example refers to an orphan drug (copper hystidinate) manufactured by a hospital pharmacy. Being aware of the strengths and weaknesses of the method, as discussed in the article, our conclusion is that our algorithm can prove a useful starting point in determining the price of drugs. Moreover, it can be modified in the future, introducing the evaluation of further parameters in order to reflect the complexity of clinical practice, “real” patients management and possible outcomes. Quality of life is one of such parameters (endpoint), becoming increasingly important.
59 citations
TL;DR: The analysis of the data collected through the CODE-2 study proves that type 2 diabetes has a high social cost, in absolute terms.
Abstract: Objective
To determine the direct, indirect and intangible costs associated with type 2 diabetes in Italy, 1998. Direct costs were grouped into three main categories, depending on they were due to diabetes, related complications, other unrelated diseases.
36 citations
TL;DR: COPD is a disease with high costs, chiefly borne by the National Health Service: even a conservative estimate would find COPD responsible for 6% of the whole health care expenditure in Italy.
Abstract: Chronic obstructive pulmonary disease (COPD) is a cause of morbidity and mortality worldwide and imposes a huge individual and social burden. The present article reports the results from the prospective phase (results from the retrospective one were already published) of a multicentre Italian study (ICE, Italian Costs for Exacerbations in COPD). The aim of ICE was to assess the direct and indirect costs due to COPD, particularly regarding its exacerbations. The prospective phase was carried out on COPD patients admitted to 25 Hospital Centres (spread throughout over the country) because of an exacerbation occurring during the quarter October–December 2002. A 6-month follow-up following discharge was performed in each patient, via three telephone interviews every second month, based on a standard questionnaire and conducted by a clinical investigator. The sample was statistically stratified by three areas: Northern, Central, and Southern Italy. 570 patients (mean age = 70.6 years; males = 69.2%) were eventually considered for processing. According to GOLD severity scale, patients were distributed as follows: 2a (moderate) → 36.4%; 2b (moderate-severe) → 31.3%; 3 (severe) → 32.3%. Respiratory failure affected 51.9% of the patients. Disease severity was found to be linked to smoking habits. 42% of exacerbations required hospitalisation. Medical costs for COPD totalled to € 4,645.5 per patient/year (€ 2,423.1 were related to exacerbations, € 2,222.4 to routine treatment); 40.1% of the total amount was for hospitalisations, 30.2% for oxygen therapy, 18% for drugs. Indirect costs (due to productivity losses by the patient and/or caregivers) were € 91.6 per patient/year. Costs resulted positively related to disease severity and to respiratory failure. COPD is a disease with high costs, chiefly borne by the National Health Service: even a conservative estimate would find COPD responsible for 6% of the whole health care expenditure in Italy. The largest share of costs is for hospitalisations; hence, a strategy might be cost-effective that aimed at reducing exacerbations by improving diagnostic procedures and different treatment strategies, including drug therapy and pulmonary rehabilitation.
30 citations
TL;DR: An original procedure is presented providing an estimate of how much some European countries have (each) de facto spent in order to produce an additional year of life — which could be viewed as one more kind of threshold value.
Abstract: Can a National Health Service afford to provide its patients with an innovative, expensive technology, face to competing alternatives? Trying to answer this question, the economic evaluation of a new medical technology aims at improving the allocation of scarce resources for health care use.
20 citations