Farmeconomia. Health economics and therapeutic pathways
Not a member yet
496 research outputs found
Sort by
Parnaparin: review of the literature
No full textSodium parnaparin is a low molecular weight heparin (LMWH). The introduction of this drug class has represented a medical advancement in the prevention and therapy of thromboembolic pathologies, as they maintain the same efficacy of unfractionated heparin, but with simplified dosing regimens and reduced side effects. Parnaparin has demonstrated its thromboprophylactic efficacy on both high- and moderate risk surgical patients, besides resulting effective in treating established deep vein thromboses and thrombosis-associated phlebopathies. Besides and independently from its antithrombotic activity, parnaparin possesses modulating effects on cells involved in inflammatory processes, which may explain its reported utility in phlebopathies other than DVT; among LMWHs available in Italy, parnaparin is the only approved for these indications. Alongside these clinical advantages, parnaparin and other LMWHs allow outpatient or home-based therapy of a large number of subjects that should otherwise be treated in hospital, with important savings of health resources and enhanced quality of life for the patients. In Italy, parnaparin drug acquisition cost is among the lowest in its class, permitting marginal savings in health costs at the same efficacy level. In summary, the use of parnaparin in thrombotic pathologies has very good efficacy and safety profiles, and has positive clinical and economical outcomes for patients, health system and society as a whole
Campania
Get PDFIn Campania region 41,8% of women (aged 25-64) are screened regularly, meaning every 3 years. Considering regional tariffs and vaccine acquisition cost, the vaccination of 12-year-old girls with a 90% coverage could prevent 208 cases of cervicocarcinoma and 84 related deaths and thus results to be cost-effective (16.130 €/QALY). When the vaccination programme is extended to 16-year-old girls a further 217 cancer cases and 89 deaths could be prevented, with a very similar cost-effectiveness ratio. In Campania region, the net cost for woman vaccinated is 182 € for the single cohort and 186 € for the multiple cohort
Abruzzo
Get PDFIn Abruzzo region 55,4% of women (aged 25-64) are screened regularly, meaning every 3 years. Considering regional tariffs and vaccine acquisition cost, the vaccination of 12-year-old girls with a 90% coverage could prevent 29 cases of cervicocarcinoma and 12 related deaths and thus results to be cost-effective (20.836 €/QALY). When the vaccination programme is extended to 16-year-old girls a further 28 cancer cases and 12 deaths could be prevented, with a very similar cost-effectiveness ratio. In Abruzzo region, the net cost for woman vaccinated is 199 € for the single cohort and 202 € for the multiple cohort
Sardegna
Get PDFIn Sardinia region 45,5% of women (aged 25-64) are screened regularly, meaning every 3 years.
Considering regional tariffs and vaccine acquisition cost, the vaccination of 12-year-old girls with a 90% coverage could prevent 38 cases of cervicocarcinoma and 15 related deaths and thus results to be cost-effective (15.347 €/QALY). When the vaccination programme is extended to 16-year-old girls a further 41 cancer cases and 18 deaths could be prevented, with a very similar cost-effectiveness ratio. In Sardinia region, the net cost for woman vaccinated is 148 € for the single cohort and 152 € for the multiple cohort
L’introduzione del vaccino anti-HPV bivalente adiuvato con AS04 nelle regioni italiane: impatto economico ed effetti sulla salute delle donne
Get PDFIntroduction: the impact of cervical cancer prevention, in particular through HPV female vaccination, has been published for many countries at the national level. However, to our knowledge no attempt has been made to address the impact at a regional level. Since the Italian health reforms of the early 1990s, introducing “managerialism”, decentralization and quasi-market mechanisms, regional authorities have consequently been experimenting with different organizational and funding models to achieve an acceptable combination of equity, efficiency, freedom of choice and cost-containment.
Methods: a Markov model, previously described and successfully adapted to the national scenario [La Torre, 2007], has been used to explore the impact of preventive cervical cancer vaccination with Cervarix™ at a regional level in Italy. Resource use was based on a standard therapeutic path applied to all regions. However we quantified the impact of the so-called “decentralization progress” by collecting regional data on: pap-test coverage, tariffs for treatments and cost of the vaccination course. We performed for each Italian region a cost-effectiveness analysis combined with a regional budget impact analysis. The regional analyses compared HPV vaccination, both of a single female cohort (12 years old) and a multiple female cohort (12+16 years old), plus screening to screening only. Results: 21 regional reports were produced presenting regional results on screening coverage, treatments costs, ICER and ICUR, net cost per subject vaccinated etc. Conclusions: national and regional analyses have two different aims: the former wants to address national regulatory agencies and needs to be representative of the national population whereas the latter deals with the real budget-holders, accountable in the eyes of patients. Furthermore in the Italian scenario, characterized by decentralization and local autonomy, a further level of detail is essential in order to describe the specific local settings and implications of a new health intervention
IDEAL trial: economic analysis
No full textIntroduction: the IDEAL (“High-dose atorvastatin vs usual-dose simvastatin for secondary prevention after myocardial infarction”) study was carried out to compare intensive lowering of low-density lipoprotein (LDL)-cholesterol using the highest recommended dose of atorvastatin 80 mg with simvastatin 20 mg. Aim: our aim was to investigate the economic consequence of high dose of atorvastatin vs usual-dose of simvastatin in reducing major coronary events in patients with a history of acute myocardial infarction (AMI). Methods: the analysis is based on clinical outcome data from the IDEAL study. We conducted a cost-effectiveness analysis, comparing high dose of atorvastatin (80 mg/die) versus usual-dose of simvastatin (20 mg/die) in the perspective of the Italian National Health Service. We identified and quantified medical costs: drug costs according to the Italian National Therapeutic Formulary and hospitalizations were quantified based on the Italian National Health Service tariffs (2008). Effects were measured in terms of morbidity reduction (frequency of hospitalizations). We considered an observation period of 4.8 years. The costs borne after the first 12 months were discounted using an annual rate of 3%. We conducted one and multi-way sensitivity analyses on unit cost and effectiveness. Results: the cost of atorvastatin therapy over the 4.8 years period amounted to approximately 2.4 millions euro per 1,000 patients. The total cost of atorvastatin high dose was about 3.9 millions euro, the incremental cost per patient free from event is 31.176,03 euro. Discussion: this evaluation found that atorvastatin therapy is cost-effective. Results were sensitive to either clinical or economic variables
Liguria
Get PDFIn Liguria region 66% of women (aged 25-64) are screened regularly, meaning every 3 years. Considering regional tariffs and vaccine acquisition cost, the vaccination of 12-year-old girls with a 90% coverage could prevent 22 cases of cervicocarcinoma and 9 related deaths and thus results to be cost-effective (24.584 €/QALY). When the vaccination programme is extended to 16-year-old girls a further 23 cancer cases and 10 deaths could be prevented, with a very similar cost-effectiveness ratio. In Liguria region, the net cost for woman vaccinated is 183 € for the single cohort and 186 € for the multiple cohort
Usefulness and limitation of DDD and PDD analyses. 12 months of solid oral antipsychotics prescribing data for the NHS-reimbursed treatment of schizophrenia in Italy
No full textThe estimation of real-world pharmaceutical costs in a given setting is one of the crucial steps in pharmacoeconomic comparisons among drugs used in that setting. For the purpose of this estimation, information regarding available pharmaceutical forms, alongside price and market share, for every considered drug is needed. Furthermore, it’s necessary to know, at least approximately, drug quantities averagely consumed in each episode, in the case of acute therapies, or on a daily basis in chronic therapies. This data is difficult to measure in non-experimental settings, and is generally approximated using the statistical average of the drug quantity prescribed by physicians for a given condition. This paper will briefly review definitions and appropriate uses of DDDs (defined daily dose), and PDDs (prescribed daily dose), and then illustrate the expressed concepts on the basis of a practical example constructed on the analysis of last available 12 months of solid oral antipsychotics prescribing data for the NHS-reimbursed treatment of schizophrenia in Italy
Toscana
Get PDFIn Tuscany region 70,2% of women (aged 25-64) are screened regularly, meaning every 3 years. Considering regional tariffs and vaccine acquisition cost, the vaccination of 12-year-old girls with a 90% coverage could prevent 51 cases of cervicocarcinoma and 21 related deaths and thus results to be cost-effective (25.732€/QALY). When the vaccination programme is extended to 16-year-old girls a further 49 cancer cases and 21 deaths could be prevented, with a very similar cost-effectiveness ratio. In Tuscany region, the net cost for woman vaccinated is 169€ for the single cohort and 172€ for the multiple cohort
Trento
Get PDFIn Trento province 72,4% of women (aged 25-64) are screened regularly, meaning every 3 years. Considering local tariffs and vaccine acquisition cost, the vaccination of 12-year-old girls with a 90% coverage could prevent 8 cases of cervicocarcinoma and 4 related deaths and thus results to be cost-effective (30.267 €/QALY). When the vaccination programme is extended to 16-year-old girls a further 8 cancer cases and 3 deaths could be prevented, with a very similar cost-effectiveness ratio. In Trento province, the net cost for woman vaccinated is 197 € for the single cohort and 199 € for the multiple cohort