1,721,159 research outputs found
Dal Monitoraggio della Spesa Farmaceutica alla aderenza al trattamento
No full textOggigiorno le politiche di incentivazione dell' appropriato utilizzo dei farmaci rappresentano una delle priorità nel comparto farmaceutico pubblico sia per il positivo impatto che possono avere sulla salute dei cittadini sia sulla spesa sanitaria complessiva. L'inappropriato utilizzo dei farmaci determina una consistente dispersione di risorse ed effetti traslativi di spesa tra diversi comparti del settore sanitario. Ecco perchè la comunità scientifica internazionale si sta muovendo in tal senso cercando azioni concrete. I pazienti anziani incidono in maniera significativa nel consumo di risorse sanitarie in generale e in particolare più del 60% del consumo farmaceutico è attribuile alla popolazione over 65. L' anziano affetto da multimorbidità è esposto a poliprescrizioni spesso inappropriate. Mettere in pratica delle strategie per migliorare l'uso dei farmaci negli anziani in politerapia può rappresentare un intervento importante oltre che per ridurre l'incidenza di rischi prevenibili e migliorare la qualità di vita dell'anziano anche per ridurre i costi della spesa farmaceutica
La terapia antiosteoporotica in regione Campania: realtà e problematiche
No full textLo studio della aderenza ai trattamenti farmacologici in real-practice rappresenta una tematica di rilevante interesse per i sistemi sanitari. L'utilizzo di banche dati amministrative sanitarie consente di stimare in maniera indiretta l'aderenza ai trattamenti farmacologici nonchè di individuare i fattori predittivi di tale fenomeno. Le analisi condotte utilizzando il database delle prescrizioni farmaceutiche in regione Campania mostrano percentuali di persistenza in trattamento con farmaci per l’osteoporosi significativamente inferiori ai dati presenti in letteratura. Azioni volte al miglioramento dell’aderenza alle terapie farmacologiche potrebbero rappresentare un vantaggio in termini di natura clinica ed economica
Attività di monitoraggio delle prescrizioni farmaceutiche: la collaborazione tra il settore farmaceutico della Regione Campania e il Centro di Ricerca in Farmacoeconomia e Farmacoutilizzazione
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Valutazione economica dello studio IDEAL
Full text linkIntroduction: 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 40 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 (2006). Effects were measured in terms of mortality and morbidity reduction (number of deaths, life years gained and 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. We also conducted a threshold analysis. Results: the cost of simvastatin or atorvastatin therapy over the 4.8 years period amounted to approximately 2.3 millions euro and 2.6 millions euro per 1,000 patients respectively. Atorvastatin was more efficacious compared to simvastatin and the overall cost of care per 1,000 patients over 4.8 years of follow-up was estimated at 4.3 millions euro in the simvastatin and 4,18 millions euro in the atorvastatin group, resulting into a cost saving of 121,518 euro that is 2.8% of total costs occurred in the simvastatin group. Discussion: this study is the first economic evaluation of IDEAL study based on the Italian context. Atorvastatin therapy is dominant since it is both less costly and more effective than simvastatin. Results of sensitivity analysis showed that atorvastatin therapy remains dominant even in the most unfavourable hypotheses
Inappropriate prescribing in elderly patients
No full textPotential inappropriate prescriptions (PIPs) in elderly population are a source of additional clinical and economic burden on healthcare systems. PIPs can derive from inappropriate dosage or duration of treatment, off-label use, use in contraindicated circumstance and in particular
drug-drug interactions (DDIs). PIPs are associated with an increased risk of drug–related adverse events, especially in the elderly population, including hospitalization and mortality. Furthermore, older patients are more at risk for PIPs because they are often treated with complex drug regimens.
The age-related changes in drug pharmacokinetics and pharmacodynamics can raise the risk of PIPs. Polypharmacy is common in the elderly population, with more than 60% receiving a simultaneous prescription of five drugs or more. There is a strong relationship between the
number of dispensed drugs and the probability of potential DDIs. The use of administrative databases signifies a significant step forward, representing a valuable tool to estimate the prevalence of clinically relevant potential DDIs as well as to examine possible predictors of
potential DDI exposure. The results show that the elderly population has a high risk of DDIs, also highlighting a very high rate of suboptimal drug prescribing in the elderly. As physicians still have some difficulty in managing this problem, the urgent implementation of national educational programs is essential, in order to highlight factors that raise the risk of DDIs and to increase an appropriate use of drugs
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