Farmeconomia. Health economics and therapeutic pathways
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Farmaci orfani e malattie rare: la situazione in Italia
No full textAim of this study is to check the Italian market of the orphan drugs in connection with rare diseases. Data for the research have been found on the Food and Drug Administration Database, the Centro di Ricerche Cliniche per le Malattie Rare “Aldo e Cele Daccò” Database and L’informatore farmaceutico. This study also compared the Italian market with the American market, that counts the greater number of designated orphan drugs and commercial authorizations in the world. In Italy only 24 orphan drugs have been authorized by the Ministry of Health and the present work analyzes their definition under the economic profile, how many diseases and what kind of pathologies they can treat, the number of products on the market and if they are refundable or not
Le valutazioni economiche in Italia: una revisione sistematica della letteratura esistente
Get PDFAim of this paper is to provide some systematic information about Economic Evaluation studies published on national and international journals by Italian authors. All studies are in Italian or English language and published between 1994 and 2000. The main source is the CESAV database, according to these keywords: “Economic Evaluation”, “Cost-Benefit Analysis”, “Cost-Efficacy Analysis”, “Cost-Utility Analysis”, Cost of Illness” and “Italy”. The study investigated the following variables: methods of analysis, illness, kind of therapy, source of data on efficacy, modelling, source of data on health resources, source of data on unit cost, type of costs, sensitivity analysis. A comparison with the main international reviews (“The U .K. NHS Economic Evaluation Database” and “The Health Economic Evaluation Database”) showed that the approach to the Economic Evaluation in Italy is consistent to the European model, even though the number of studies is still less than in other States
I costi dell’influenza in Italia
Get PDFThe influenza is an acute viral infection that strikes respiratory tract and its diffusion is characteristic of epidemic and pandemic reoccurence. Globally the influenza represents, for the entity of its social impact (measurable in terms of morbility, hospitalization and mortality), a heavy healt care problem. In Italy the estimated incidence is 10-15%: the influenza is the third death cause for infectiuos disease, after AIDS and tubercolosis. This study is based on the Studio 606, the first italian study that allow us to pass from the presumptive phase to the observational one. The Studio 606 has been projected and realized by the Società Italiana di Medicina Generale (SIMG), involving about 200 general practitioners (MMG) in two sample region, Lombardia and Puglia. The study has been developed between December the 15th, 1998 and March the 15th, 1999. The influenza causes especially indirect costs: most of people affected with influenza doesn’t go to work for about five days and these absences create an average cost per capita of £558.000. This indirect cost represents 87% of total average cost of one single influenza event
Costruzione di un modello decisionale per valutare la costo/efficacia delle strategie alternative nella terapia della polmonite acquisita in comunità
Get PDFAim of this paper was to analyse the cost effectiveness of the main alternative (and complementary) strategies in the disease menagement of the Community-Acquired Pneumonia (CAP): hospital admission vs home-care, antibiotic parental vs oral therapy, switch vs no-switch therapy, and early discarge vs conventional hospitalization. The cost effectivenessanalysis (CEA) has been performed by implementing a general decision tree model wich describes all the main decisional and change nodes encountered in the clinical course from the firm sign and symptoms of CAP (root) to the final aoutcomes: full recovery or death (terminal nodes). We assumed the perspectives of three main institutional decision-makers: the society, the italian national healthcare system (NACS), and the hospital. In the perspective of society both the direct (health and non-health) costs and the indirect costs have been included, while in the perspective of the NACS only the health-direct costs were considered. In the perspective of the hospital we considered the overall mean expences sustained for each day of staying in the general and in the intensive care unit. Separately, the antibiotic treatement costs to hospital have been accounted. As effectiveness we considered the percentage of recovery for each class of mortality aqccording to fine. Most of the probability data used in the model were obtained or derived from the published literature. The cost were valued according to the Italian NACS charges and prices in use during the year 2000. According to the model structure, the main expenditure factor for the SSN is the hospitalization cost, while the home care is less expensive. The antibiotic parentenal therapy, during hospedalization or home care, is more expensive than the antibiotic oral therapy; but the cost difference between one therapy and the other is clearly lower than the cost difference between the hospitalization and the home care. The optimum expenditure situation for the SSN, the Society and also for the Hospital coul be obtained by decreasing the days of hospital stay in and by choosing to hospitalize the patients according to the death risk. The sensitivity analysies performed confirmed the robusteness of the results obtained with the model. However the model and its usefulness in decision-making will be definitely confirmed when clinical and epidemiological robust data on CAP in Italy will be available
L’uso ospedaliero di ciprofloxacina nella terapia parenterale ed orale delle infezioni gravi: profilo farmacoeconomico
Get PDFThe study focuses on the microbiological and economic aspects of the treatment of hospital infections. The following topics are presented and discussed: I) principal microbiological features of infections acquired during hospital stays; II) data on the use of fluoroquinolones in hospital patients; III) cost-analysis of hospital infection treatment; IV) impact of different antibiotics on the selection of resistant strains of Pseudomonas aeruginosa; V) review of pharmacoeconomic data of different antibacterial regimens
Ketorolac vs. morfina nel trattamento del dolore acuto in pazienti traumatizzati: un’analisi di minimizzazione dei costi
Get PDFAim of this study is to develop an economic valuation comparing ketorolac vs. morphine for the treatment of sharp pain caused by heavy limb injury, in traumatology ward and in first aid ward. As cost minimization analysis, this economic valuation has been based on clinical results of Rainer et al. (2000). Ketorolac and morphine have the same efficacy in calming the pain; the greatest difference in the clinical outcomes is about the morphine side effects (nausea, vomiting and phlebitis). Assuming the hospital point of view with a differential costs perspective, the ketorolac patients showed two consequences than could generate lower resources consumption: less side effects and the reduction of time permanence in first aid ward. Considering the drug cost, the administration cost and the side effects treatment costs, the expenditure for every single morphine patient is L. 23.385, vs L. 4.875 for a ketorolac patient, with a difference of L. 18.510
L’effetto delle operazioni di fusione e acquisizione sui profitti degli azionisti nell’industria farmaceutica
Get PDFThe purpose of this study was to quantify the excess return in shareholder security prices following initial announcements of successful horizontal pharmaceutical mergers which occurred between 1985 and 1996. An event study methodology was used to study a sample of26 fim1s involved in 14 mergers wherein transaction costs exceeded $500 million. Overall, results of the study were consistent with prior research, indicating that target-firm shareholders received a majority oft he short-term merger-related wealth effects in comparison to those received by bidder- firm shareholders
I costi delle Terapie Intensive italiane
Get PDFIn the 1995 the (GiViTI started a programme for the research about the economic features of the Intensive unit in Italy. After a preliminary check on available data, the GiViTI research considered 30 multipurpose ICUs during the period between 1996 and 1998. Every selected units received a questionnaire to fill up with information about staff, drugs and blood derivatives, other medical products, diagnostic and therapeutic services. The studied departments held on average 8 beds and their overall annual costs came to £ 3,4 billion. The single patient costs was £ 9,9 million and one day of stay in hospital amounted £ 1,3 million. These expenditures were allocated according to this percentage: 62% far the staff; 12% far drugs and blood derivatives, 12,7 for other medical products, 7% for laboratory services and 6,3% for different diagnostic and non sanitary services. Besides, the research showed the presence of scale economies production in the Italian multipurpose ICUs, even if only for the work costs. The GiViTI programme now is tackling the next phase, that studies the relations between treatment costs clinical characteristics of patients
La day surgery centralizzata: l’appropriatezza clinica e organizzativa come leva di creazione di valore sanitario
No full textIn the last years Public Health Service has been trying to find out solutions in order to improve its health value added creation capacity. The implementation of the Day-surgery division mainly aims to follow that direction, since it enables the improvement of the ratio between efficacy, quality and healthcare suitability and on the other hand efficiency, costs and modality of better resources utilization. The centralization of Day-surgery activities proposes some innovative characteristics, concerning that it introduces an organizational model focused on needs and it performs the separation of the clinic and therapeutic activities from the ones involving the assistance. Both economic and qualitative advantages deriving from the changes stand out in term of: - high possibility of activities’ scheduling; - improved customer satisfaction; - rationalisation of day-hospital recovery, with positive effects on the inpatients; - improved hospital economic stability. This study was carried out with the support of the multiple-skill group composed of doctors, nurses, administrative staff as well as experts in the field of organisation with an aim to provide the full outline of the necessary competences. The proposed discussion reflects the multidisciplinary view of the problem and different perspectives. Each of them regards particular aspects and implications indicated as following: - clinical perspective, related to the possibility of day-surgery interventions both from the medical and the anaesthetic point of view; - organisational perspective, which refers to the possible day-surgery models in conjunction with the organisational model and their peculiarities; - operative perspective, which consist of the analysis of the ideal structural dimension, flows of activities among all services involved and the analysis of the productive capability; (number of necessary beds, staff dimension and a relapse of the operation activities needs); - economic perspective, focused mainly to provide the final valuation on the capacity of the project to contribute to the improvement of the hospital
Valutazione farmacoeconomica di una casistica di pazienti con riacutizzazione di bronchite cronica
Get PDFAim of this study is to operate a pharmaeconomical evaluation on case histories of patients affected by chronic bronchitis relapse, comparing the effectiveness of different molecules with antibiotic activity and the total cost far each considered drogo. The observational retrospective study has been conducted at the Bronchopncumology Depaliment of the E. Morelli Hospital (Reggio Calabria) on 344 patients aftècted by acute infective or chronic relapsed bronchopneumopaties between January, the 1st, 1997 and December, the 31th 1999. To avoid excessive data dispersal, the study considered only the active principles prescribed to at least 50 persons: ceftazidime, ceftriaxone, cefepime and piperacilline + tazobactam. AlI the patients have responded positively to the treatment, so the cost minimization analysis has been carried out far every dosage regimen, considering different parameters: nursing staff costs, consumable material and drug costs. The Prescribed Daily Dose (PDD) has been taken as unit of measurement for drug costs. The single adminstration cost is based on nursing costs and consumable material costs. To get the total therapy cost, it’s necessary to add the single administration drug costo. In this study, the lowest total cost is guaranteed by treatment with ceftriaxone