Farmeconomia. Health economics and therapeutic pathways
Not a member yet
496 research outputs found
Sort by
Valutazione clinica e metabolica dell’impiego dell’insulina Lispro in pazienti con diabete mellito scompensato
Get PDFThe aim of the present work is to report preliminary results about the administration of an insulin analogue, LisPro, to treat diabetic chetoacidosis. This new procedure, in respect to insulin continuous infusion, allow significant cost reduction in terms of medical and nurses time dedicated to the patient and hospitalization length. In our experience, LisPro treatment compared to the standard of care, has allowed hospital time reduction of 2,1 days per patient. This can be translated in cost saving of about 700,00 euro per case. These preliminary data, replicating the results coming from published international experiences, have to be confirmed in our country through the implementation of more representative studie
Commenti all’articolo: “Interruzione del trattamento nei pazienti con schizofrenia che ricevono olanzapina o aripiprazolo: metanalisi degli studi clinici controllati”
Get PDFParnaparin: confronto con le altre eparine a basso peso molecolare
Get PDFSodium 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. 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 for many applications, 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
Valutazione economica dei costi associati al trattamento di pazienti in ossigenoterapia a lungo termine, con o senza monitoraggio telemetrico domiciliare
Get PDFLong term oxygen treatment (LTOT) represents an helpful, even though costly, therapeutic strategy for managing severe chronic respiratory diseases at home. The aim of the present study was to assess the economic impact of adding the home telemetric monitoring of some vital signs to the traditional domiciliary LTOT in this kind of patients. Two samples of severe chronic respiratory patients (COPD patients in 89% of cases, managed at home without, n=20, and with, n= 61, telemetric home monitoring) were compared for a 24-month period, and the corresponding outcomes measured. In the tele-monitored group of subjects, both the mean number and the mean duration of hospitalisations dropped along the two-year study, together with the n. exacerbations/ patient/year. The mean annual cost for the tele-monitored group of patients was lower by 28% in the first year, and by 33% in the second year of the study. The home tele-LTOT management of patients with severe chronic respiratory disease, mostly COPD, allows a better clinical control of the disease, with a corresponding 50% reduction of exacerbations leading to hospitalisation. Finally, the home tele-LTOT contributes substantially in minimizing the economic impact of these severe chronic respiratory diseases
Il federalismo in sanità: opportunità e rischi tra finanziamento, equità ed assistenza
Get PDFFederalism in Italy arised beginning ’90, pushed bipartisanly from establishment in order to contrast the succesfull poll of northern league party. Being about 80% of the regions budget for healthcare, federalism had its hard impact on it. Regions can manage autonomously their healthcare organization, adding to the State financial resources own money earning from other their services or coming from local taxes, on condition that they provide the State LEA (Essential Level of Assistance). That means a high level of responsabilization for local government for reaching a higher level of efficiency in allocation of resources and organizational models of production and erogation of healthcare, beside a better ability to catch local healthcare demand. Even if now the sharing of State financial resources are agreed between all regions and Government, it’s not clear for the future wheter each region will have to procure its own finance, introducing many problems for those southern regions unable to substain theirselves. It has still to be defined wheter and how reach regions will have to transfer part of their resources to the poor ones. That means a risk of iniquity of level in healthcare provision among regions of the same country, generating possible social conflict. Therefore federalism now has from a hand the opportunity to better tail healthcare on each local demand and, on the other hand, it risks to introduce social disparity and conflicts
Costo/efficacia della prevenzione di infezioni alle prime vie aeree mediante un estratto batterico immunostimolante aspecifico (OM-85)
Get PDFOBJECTIVES: To estimate the pharmacoeconomical impact of preventing recurrent upper respiratory tract infections (URTIs) with OM-85, a non-specific immunostimulating agent, in at-risk children. METHODS: Implementation of a decisional model. The evaluation of effectiveness (number of prevented URTIs/therapeutic cycle) was based on weighted average of the results of four randomized, double-blind, placebo-controlled trials identified by literature reviewing. The clinical events considered in the model were natural resolution of the infection, onset of complications (acute otitis media, sinusitis, others) and their evolution. Baseline event probabilities were derived by reviewing published data in the literature. URTI-related direct and indirect costs supported by patient, by Italian health system and by community were structured according with the principal guidelines and implemented with current Italian prices and tariffs. The cost/ effectiveness of OM-85 was calculated for five scenarios, differing in the number of therapeutic cycles, grade of patient co-payment and other secondary assumptions. Sensibility analyses were performed to evaluate the model robustness. RESULTS: Immunostimulation with one cycle of OM-85 prevented on average 1,60 URTI/patient in six months (RR = 0,515). In the basic scenario, this preventive action induced savings for 107,42 euro/patient in the perspective of the patient’s family, for 48,52 euro/patient in the perspective of Italian health system and for 231,26 in the community perspective. Sensibility analyses confirmed the robustness of basic scenario results. Threshold analyses showed that OM-85 prophylaxis is economically convenient as long as more than 7% of infections are prevented or global cost of one episode of URTI is greater than 10,00 euro. CONCLUSIONS: Non-specific immunotherapy with OM-85 induces a reduction in the incidence of URTIs in atrisk children with a concurrent saving for patient and health system
La valutazione economica del trattamento farmacologico con antipsicotici nella schizofrenia: una revisione sistematica della letteratura
Get PDFSchizophrenia is a chronic, severe, and disabling brain disease. Approximately 1 percent of the population develops schizophrenia during their lifetime. Available treatments can relieve many symptoms, but most people with schizophrenia continue to suffer some symptoms throughout their lives; it has been estimated that no more than one in five individuals recovers completely. The introduction of second-generation antipsychotics, also defined as atypicals, has increased the therapeutic options available for individuals with schizophrenia. Potential benefits of these agents include a more favourable profile in terms of positive and negative symptoms, less adverse effects and better cognitive functioning than first-generation antipsychotics. It is uncertain whether atypical antipsychotic agents, as prescribed in ordinary practice, are a cost-effective alternative to conventional agents. This study examined the financial and clinical implications of using atypical antipsychotics in the treatment of schizophrenia, considering both related costs and consequences. To elaborate the paper, we reviewed 8 economical studies regarding the comparison between atypical and typical antipsychotics, published in the years 1998-2004. In 5 studies atypical antipsychotics were cost-saving compared to typical, in 2 studies they were cost-neutral and in one study they resulted cost-effective. Consequently typical antipsychotics were cost-saving just in one study
Le benzodiazepine nel trattamento dell’ansia: profilo clinico e farmacoeconomico
Get PDFAnxiety disorders impose a significant economic burden on healthcare system, patients and society as a whole. A patient with anxiety disorders, especially with panic disorder, shows some difficulties to work or to maintain an acceptable social functioning, and, frequently, needs more medical care than a normal subject, often due to unnecessary or inappropriate diagnostic tests. Adequate psychiatric treatment of anxiety disorders can lead to higher direct specialists costs (psychiatric drugs and visits) but this may be offset by a decrease in non-specialist care costs and in indirect costs. Benzodiazepines have been extensively used for the treatment of anxiety and related disorders since the 1960s. Although new pharmacological and psychological treatments for anxiety are available, a lot of psychiatrists continue to endorse benzodiazepines as primary or adjunctive treatment for these disturbs, especially in the early or acute phases of the illness. In Italy, benzodiazepines have been available also as generic drugs for some years. In order to be accepted for marketing, a generic drug has to demonstrate bioequivalence, considered a reliable proxy of therapeutic equivalence, with the standard formulation and its price has to be at least 20% cheaper than the originator drug. The use of generic drugs can contain drug expenditures and facilitate a competitive market. Despite that their prices are considerably higher than those of generics, branded benzodiazepines are still widely prescribed, because of prejudices and lack of information in the community of physicians and patients. In conclusion, benzodiazepines may treat anxiety disorders, mainly in early and acute phases, increasing quality of life and saving medical resources. The availability of generics allows for marginal reduction in initial investment in drug costs
L’uso appropriato di antibiotici iniettivi a domicilio: criteri epidemiologici, clinici e farmacoeconomici
Get PDFOutpatient parenteral antibiotic therapy (OPAT) has become an increasingly used therapeutic modality during the last 20 years. Reasons for this rapid growth include OPAT’s many patient benefits as well as the development of new technologies and well-documented cost savings. Recently the Italian Drug Agency (AIFA) has revised the list of drug’s limitations and indications; particularly two notes about OPAT (n. 55- n.56) have been modified. These new notes can assume at least a double significance: if on the one hand they try to put a check on the overuse and misuse of OPAT, steering physicians towards a better utilization of parenteral antibiotics, on the other they allow to prescribe OPAT also in case of non-ordinary infections, promoting development of more structured OPAT programmes. Prescribing physicians should be aware of a number of aspects of OPAT which distinguish it from other forms of therapy: multiple factors must be taken into account, including the probable infecting organism, the pharmacodynamic and pharmacokinetic properties of candidate drugs, the capabilities of patients who will receive OPAT and of their caregivers. The Infectious Diseases Society of America (IDSA) Guidelines have been elaborated to help physicians thorough assessment of OPAT suitability, even if they need to be adapted to many variables in each treatment setting. Aim of the present study is to re-consider the main microbiologic, clinical and pharmacoeconomic criteria supporting the prescription of an outpatient parenteral antibiotic therapy after the publication of the new AIFA notes