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Articles de revues sur le sujet « Costo-efficacia »

Auteur : Grafiati
Publié le 9 mars 2023
Mis à jour le 10 mars 2023

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1

Matarese, Alessandro, Pier Giorgio Calò, Gabriele Materazzi, Viola Villardita, Maurizio Iacobone, Antonella Pino, Paolo Carcoforo et al. « Analisi costo-efficacia del neuromonitoraggio nella chirurgia della tiroide ». L'Endocrinologo 23, no 3 (juin 2022) : 290–96. http://dx.doi.org/10.1007/s40619-022-01085-6.

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SommarioVi sono prove sempre più rilevanti circa l’importanza di una più dettagliata valutazione dei costi delle nuove tecnologie usate in chirurgia. L’impatto innovativo della tecnologia ha il potenziale per ottenere miglioramenti clinici rivoluzionari. Tuttavia, esistono informazioni limitate sul tema costo-efficacia delle nuove strategie chirurgiche usate in chirurgia tiroidea. In questo studio descriviamo le recenti evidenze relative ai metodi di valutazione costo-efficacia delle strutture e delle funzioni per il neuromonitoraggio intraoperatorio (IONM) in chirurgia tiroidea. I nostri risultati suggeriscono che il modello di economia sanitaria, nell’elaborazione della struttura degli studi costo-efficacia relativi al neuromonitoraggio intraoperatorio, si è dimostrata realizzabile come metodo per migliorare l’efficacia della ricerca.
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Mauskopf, J., F. Rutten et W. Schonfeld. « Le league tables di costo-efficacia ». PharmacoEconomics Italian Research Articles 6, no 3 (novembre 2004) : 131–40. http://dx.doi.org/10.1007/bf03320631.

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Eandi, Mario, Lorenzo Pradelli et Chiara Benedetto. « Utilità e costo/efficacia del dinoprostone in ostetricia ». Farmeconomia. Health economics and therapeutic pathways 3, no 3 (15 septembre 2002) : 135–46. http://dx.doi.org/10.7175/fe.v3i3.751.

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Pregnancy-related hypertension, intrauterine growth retardation, post-maturity and unfavorable local conditions are among the most frequent indications for labor induction. There are two competing strategies for the induction of labor in term pregnancies: formal induction with artificial rupture of the membranes and/or intravenous oxytocin on one side, and cervical ripening and induction with exogenous prostaglandins on the other. The use of prostaglandins in obstetrics relies on two pharmacological properties: the capacity of inducing the biochemical changes in the connective tissue of the cervix that lead to its maturation and the stimulation of the uterine smooth musculature. While the latter property is shared with oxytocin, the former offers great clinical advantages, in particular in those women that present an indication for labor induction but whose cervix, normally assessed with the use of the Bishop score, does not show “ripeness”, i.e. does not permit vaginal delivery. Since the acquisition cost of the prostaglandins is quite high, but the clinical benefit appears evident, several studies have analyzed the overall economical impact of their use, both as pre-induction cervical ripening agents and as induction drugs. When compared to a strategy of expectant management in term pregnancies without cervical ripeness, exogenous prostaglandin administration has proven to be more cost-effective and better accepted by the patients. Prostaglandins have also proven to be more cost-effective than oxytocin and/or amniotomy in women with an indication to labor induction and unripe cervix, due to the reduced number of induction failures and cesarean sections required with this strategy. The economical analyses that have compared oxytocin and prostaglandins in women with ripe cervices deliver more ambiguous data, but it appears that their cost-effectiveness is comparable. Furthermore, none of the reviewed studies has considered intangible costs, but it is a wide-spread opinion that induction with prostaglandins results in a more “natural” and less painful labor.
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Iannazzo, Sergio, Lorenzo Pradelli, Roberto W. Dal Negro et Mario Eandi. « Analisi di costo efficacia nella terapia della BPCO ». Farmeconomia. Health economics and therapeutic pathways 6, no 4 (15 décembre 2005) : 277–87. http://dx.doi.org/10.7175/fe.v6i4.843.

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Current practice guidelines for the treatment of COPD recommend the use of combined inhaled corticosteroids and long-acting bronchodilators in severe and very severe patients (GOLD stages III and IV). OBJECTIVES: To analyze the economical and clinical impact of this recommendation, the affordability of its widespread application, as well as the relative pharmacoeconomical performance of the available options for severe and very severe COPD in Italy. METHODS: Published data on the Italian COPD population were fitted in a disease progression model based on a Markov chain representing severity stages and death. Alternative therapeutic options (salmeterol/ fluticasone - SF, formoterol/budesonide - FB, salmeterol alone - S, fluticasone alone - F and control - C) were represented as competing arms in a decision tree. Efficacy data from international trials were expressed in terms of risk reduction. Clinical parameters used were number of exacerbations and symptom-free days. Direct and indirect costs were considered and valued according to present prices and tarifs. The analyses were conducted from National Health System, societal and patient perspectives with time horizons of 1,5, and 10 years, and lifelong. RESULTS: The yearly total direct costs of treating COPD patients in Italy is estimated in approximately 7 billion Euro, with a mean cost/patient/year around 2,400 Euro. Mean survival of the cohort is 11,5 years. The C and F strategies are dominated (i.e. are associated with worse outcomes and higher costs) by all alternatives. S/F and F/B are the most effective strategies, with a slight clinical superiority of the latter, but are also marginally more expensive than S. Incremental cost/effectiveness of S/F vs. S is 679,55 Euro/avoided exacerbation and 3,31Euro/gained symptom-free day. CONCLUSIONS: The recommended use of combined inhaled corticosteroids and long-acting bronchodilators for severe and very severe COPD patients, as compared with current practice, has the potential of improving clinical outcomes without increasing health care costs.
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Berto, Patrizia, et S. Lopatriello. « Efficacia clinica e costo-efficacia di atorvastatina a elevati dosaggi nella prevenzione degli eventi cardiocerebrovascolari ». Giornale Italiano di Health Technology Assessment 4, no 1 (août 2011) : 17–31. http://dx.doi.org/10.1007/bf03320740.

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Eandi, Mario. « Costo-efficacia dell’amfotericina B liposomiale nella terapia dell’aspergillosi invasiva ». Farmeconomia. Health economics and therapeutic pathways 5, no 1 (15 mars 2004) : 47–61. http://dx.doi.org/10.7175/fe.v5i1.786.

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Invasive aspergillosis (IA) is a common and life-threatening infectious complication of immune system depression. Amphotericin B deoxycholate (AMB-d) has been considered standard therapy for IA for over 40 years, despite the fact that success rates rarely exceed 40% and adverse effects are quite common. At present two more recent pharmacological agents are available for the treatment of IA: liposomal amphotericin B (L-AMB) and voriconazole (VOR). In this article, we present a pharmaco-economical study comparing the relative costeffectiveness of 5 alternative strategies in the treatment of invasive aspergillosis, analysed from the point of view of the Italian hospital: administration of L-AMB as first line therapy, followed by no rescue treatment in case of failure (L-AMB I°); administration of L-AMB as first line therapy, followed by VOR in case of failure (LAMB I° + VOR rescue); AMB-d as first line, followed by L-AMB in case of failure (L-AMB rescue); AMB-d as first line, followed by other antifungals as needed (AMB-d I°) and VOR as first line, followed by rescue treatments in case of failure (VOR I°). The cost-effectiveness analysis was conducted using decision tree modelling techniques: efficacy data were obtained from published clinical trials; costs parameters were fitted on the Italian setting. The results indicate that two strategies, L-AMB rescue and VOR I°, are dominated, i.e. induce higher costs and lower success rates than the alternatives. The three remaining strategies are neither dominated nor dominate the others, but are associated with different clinical and economical outcomes: AMB-d I° has the lowest total cost, but also the highest cost-effectiveness ratio and the lowest overall efficacy; L-AMB I° has the best cost-effectiveness, but requires the willingness to pay 2,100 euro for each additional success; L-AMB I° + VOR rescue is the most effective treatment, but this choice is associated with incremental costs of 17,200 euro for each additional success, compared with L-AMB I°. In conclusion, our analysis indicates that for clinical, economical and ethical reasons the best option in the treatment of IA is the administration of L-AMB as first line therapy, thus limiting the use of VOR to the rescue of the patients not cured by this approach.
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Bondonio, Piervincenzo. « Le analisi costo della malattia e costo efficacia in farmacoeconomia. Ambiti di applicabilità, problemi, prospettive ». Farmeconomia. Health economics and therapeutic pathways 1, no 1 (15 mars 2000) : 9–18. http://dx.doi.org/10.7175/fe.v1i1.707.

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Aim of the paper is to compare and evaluate some of the main features of two different tecniques of economic analyses: cost of illness e and cost-effectiveness. The former is not so widely used in pharmacoeconomics, while the latter is dominant. Although their theory has recently much progressed, their practice is still hindered by some unresolved questions, to which the paper also addressess.
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Berto, Patrizia, M. Breccia et R. Latagliata. « Analisi costo-efficacia di dasatinib nella prospettiva del SSN italiano ». Giornale Italiano di Health Technology Assessment 3, no 1 (juillet 2010) : 13–29. http://dx.doi.org/10.1007/bf03320729.

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Eandi, Mario, Nicola Giotta et Gaia Santagostino Barbone. « Analisi costo/efficacia di sevelamer nel trattamento dell’iperfosforemia del paziente in dialisi ». Farmeconomia. Health economics and therapeutic pathways 5, no 4 (15 décembre 2004) : 201–18. http://dx.doi.org/10.7175/fe.v5i4.809.

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Dialysis-associated hyperphosphatemia has been treated with chelating calcium salts, in particular with calcium carbonate. A new option for the management of this problem is represented by sevelamer, a chelating agent which contains no calcium and no metals. Sevelamer and calcium carbonate are more or less equally effective and tolerated. The prolonged use of sevelamer instead of calcium carbonate, nevertheless, reduces calcemia and C-reactive protein levels, with a consequent reduction in myocardial infarction, angina pectoris and other peripheral vasculopathies. The limit to the wide-spread use of sevelamer is in its very high acquisition cost, as compared to the alternative. In this article, a semi-markovian pharmacoeconomical model for the comparison of clinical and economical outcomes of sevelamer and calcium carbonate is presented. The analysis is conducted in the perspective of the Italian health system (SSN). Clinical data are derived from published studies and integrated with expert panel estimates, cost data are relative to the Italian setting. The incremental cost-effectiveness analysis indicated that sevelamer is more costly, but also more costeffective: a one month gain in survival costs the SSN additional 2710 Euro, a value inferior to the conventionally accepted willingness-to-pay of industrialised countries. The majority of this excess cost is derived from the gain in survival, and consequent increase in dialysis costs. Thus, the choice of using sevelamer instead of calcium carbonate is even more justified from an ethical point of view. Sensibility analyses confirmed the robustness of the basic scenario results.
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Liuzzi, Michele. « Per un progetto nazionale di psicologia di cure primarie ». PSICOLOGIA DELLA SALUTE, no 2 (août 2020) : 158–75. http://dx.doi.org/10.3280/pds2020-002008.

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L'articolo riporta un'esperienza di intervento di psicologia di cure primarie a Torino, nel quale vengono affrontati i temi più rilevanti, le caratteristiche, i punti di forza e le criticità di tali progetti. L'intento è quello di fornire informazioni e dati al fine di dare un ulteriore contributo al dibattito all'interno della comunità scientifica che porti alla creazione di servizi di psicologia di cure primarie a livello nazionale. Vengono presentati gli aspetti cruciali che caratterizzano il modello, accessibilità, gradualità, efficacia clinica e costo–efficacia. Accessibilità poiché tali servizi devono essere posizionati sul territorio, vicini ai luoghi di vita dei cittadini, flessibili e inclusivi. Gradualità poiché gli in-terventi debbono essere appropriati come intensità rispetto alle esigenze di salute. Efficacia cli-nica poiché è fondamentale dare il giusto trattamento al determinato disturbo del paziente. Co-sto-efficacia poiché gli interventi debbono essere appropriati al problema del paziente, tempe-stivi in modo da anticipare patologizzazione e cronicità, e inoltre devono svolgere una funzione di filtro per i servizi secondari e i dipartimenti di emergenza. Vengono altresì presentati alcuni risultati rispetto al medical cost offset di tali interventi, in particolare sugli effetti pre-post che l'intervento ha generato su prescrizioni farmacologiche, numero di invii ai servizi specialistici, e numero di visite dal medico di famiglia. Questi progetti nelle realtà internazionali più avanzate sono da tempo operanti, e le recenti vicende (Decreto Calabria) sono una testimonianza di quanto sia necessario realizzare tali ser-vizi. L'autore porta quindi alcune proposte in tal senso.
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Eandi, Mario, Elisa Berno et Lorenzo Pradelli. « Analisi costo/efficacia della doxofillina vs. teofillina nella terapia dell’asma cronica reversibile dell’adulto ». Farmeconomia. Health economics and therapeutic pathways 3, no 2 (15 juin 2002) : 103–17. http://dx.doi.org/10.7175/fe.v3i2.748.

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Doxofylline is a methyl-xanthine with bronchodilator activity which clinical efficacy in the treatment of asthma and COPD is equivalent to theophylline. Clinical trials prooved that while doxofylline is as effective as theophylline in the treatment of asthma, it is associated with lesser side effects. For our pharmacoeconomical evaluation, we employed the data of an international multi-centric study that compared the efficacy and tolerability of 12 weeks of treatment with either theophylline 250 mg tid, or doxofylline 400 mg tid, or placebo. The efficacy was evaluated with pulmonary function tests and by recording the number of asthma attacks and beta-2 agonist puffs: doxofylline 1200 mg/day and theophylline 750 mg/day resulted equally effective, but the former resulted better tolerated, as the adverse effects were lesser in number and severity. We performed a cost/effectiveness analysis in order to compare the two treatments, considering the perspective of the Italian health system (SSN) and of the Italian society. For the purposes of this analysis, the efficacy indices we considered were two: one simple, consisting in the number of avoided asthma attacks (AAA), and a more complex one, i.e. UATD (Utility Adjusted Therapy Days). For the construction of this index, we extracted the survival curve of the patients remaining in therapy; this curve showed that the cumulative number of therapy days is significantly greater in the doxofylline group, although the percentage of dropouts is similar at the end of the three months: this is due to the fact that the drop-outs in the theophylline group occur earlier after treatment start. The number of therapy days was then weighed for an utility index inversely proportional to the main daily number of avoided asthma attacks, thus obtaining the UATDs. The results of the cost/effectiveness analyses showed that doxofylline dominates theophylline treatment in asthma, as it is less expensive and more effective (in terms of AAAs and UATDs) for both considered decision-makers, i.e. Italian SSN and society. The consistency of these results was further confirmed by oneway sensitivity analyses.
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Franzosi, Maria Grazia, A. P. Maggioni, E. Santoro, G. Tognoni et E. Cavalieri. « Analisi costo-efficacia dell’impiego precoce di lisinopril nei pazienti con infarto miocardico acuto ». PharmacoEconomics Italian Research Articles 2, no 1 (septembre 2000) : 43–52. http://dx.doi.org/10.1007/bf03320573.

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Russo, Pierluigi, E. Attanasio, O. Leri, F. Fiocca et G. I. Togna. « Analisi costo-efficacia di due combinazioni sequenziali di trattamenti di eradicazione dell’Helicobacter pylori ». PharmacoEconomics Italian Research Articles 3, no 1 (mars 2001) : 15–25. http://dx.doi.org/10.1007/bf03320576.

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Toraldo, D. M., D. Passali, A. Sanna, F. De Nuccio, L. Conte et M. De Benedetto. « Cost-effectiveness strategies in OSAS management : a short review ». Acta Otorhinolaryngologica Italica 37, no 6 (décembre 2017) : 447–53. http://dx.doi.org/10.14639/0392-100x-1520.

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L’apnea ostruttiva del sonno (OSAS) è una malattia cronica eccessivamente sotto-diagnosticata con un’alta prevalenza negli adulti. L’OSAS sta diventando un problema sociale significativo perché associata ad un peggioramento della qualità della vita ed un aumento della mortalità. Il rapporto costo-efficacia nella gestione diagnostica e terapeutica dell’OSAS è un problema strategico per contrastare la crescente domanda di test oggettivi. I pazienti OSAS che non presentano comorbilità clinicamente evidenti devono essere studiati utilizzando un sistema semplificato e poco costoso, come l’Home Sleep Testing (HST). Al contrario, la Sleep Laboratory Polisomnography (PSG) rimane il gold standard per la gestione dei pazienti con OSAS in presenza di comorbidità. Occorre sottolineare che l’uso di HST potrebbe portare ad una diagnosi errata in soggetti OSAS non ben selezionati. Questa breve rassegna si propone di offrire argomenti di riflessione sulla corretta diagnosi e trattamento dell’OSAS, in rapporto ai dati di prevalenza e alle ricadute sui costi/benefici sociali della malattia. Attualmente non può essere solo il rapporto costo/efficacia a definire il modello organizzativo adottato per la gestione dell’OSAS, in quanto si rendono necessari ulteriori studi prospettici a lungo termine, volti a validare in maniera definitiva tale rapporto nonché il confronto tra il trattamento con modelli di gestione ospedaliera versus l’assistenza domiciliare.
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Falavigna, Greta, Roberto Ippoliti et Grazia Lomolino. « Implementazione di un programma di controllo delle infezioni ospedaliere : un'analisi di costo ed efficacia ». MECOSAN, no 89 (mai 2014) : 125–52. http://dx.doi.org/10.3280/mesa2014-089008.

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Ravasio, Roberto, et L. Ferrannini. « Costo-efficacia di risperidone iniettabile a rilascio prolungato nel trattamento della schizofrenia in Italia ». PharmacoEconomics Italian Research Articles 8, no 1 (janvier 2006) : 19–31. http://dx.doi.org/10.1007/bf03320555.

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Mennini, Francesco Saverio, Martina Paoletti, Chiara Bini, Andrea Marcellusi, Marco Falcone et Massimo Andreoni. « Cost-utility analysis of ceftolozane/tazobactam vs meropenem in patients with hospital-acquired pneumonia (HABP) or ventilator-associated pneumonia (VABP) ». Global & ; Regional Health Technology Assessment 9 (7 avril 2022) : 45–57. http://dx.doi.org/10.33393/grhta.2022.2287.

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Obiettivo: Questo studio ha lo scopo di valutare il rapporto costo-efficacia di ceftolozano/tazobactam rispetto a meropenem per il trattamento di pazienti con polmonite acquisita in ospedale (HABP) o polmonite associata a ventilazione meccanica (VABP) sia secondo la prospettiva del Servizio Sanitario Nazionale (SSN), sia secondo la prospettiva sociale. Metodo: L’analisi è stata condotta mediante lo sviluppo di un albero decisionale e di un modello di Markov al fine di catturare rispettivamente gli effetti di breve e di lungo periodo. Una popolazione target ipotetica di 1.000 pazienti con vHABP/VABP è stata seguita per un orizzonte temporale lifetime (40 anni). In particolare, con riferimento all’albero decisionale di breve termine, sono stati sviluppati due diversi setting al fine di valutare il valore della terapia empirica rispetto all’avvio del trattamento dopo la conferma dell’antibiogramma. I pazienti trattati e guariti entrano nel modello di Markov di lungo termine seguendo la mortalità della popolazione generale. Risultati: L’analisi ha evidenziato come ceftozolano/tazobactam, in entrambi i setting di trattamento (empirico e confermato), possa risultare un’opzione costo-efficace rispetto a meropenem sia nella prospettiva del SSN sia nella prospettiva sociale (ICER per QALY rispettivamente pari a € 1.913 e pari a € 2.203 per il setting di trattamento empirico e rispettivamente pari a € 6.163 e pari a € 6.597 per il setting di trattamento confermato). Conclusioni: Alla luce dei risultati emersi dall’analisi, è possibile notare come l’introduzione di ceftolozano/tazobactam all’interno del contesto sanitario italiano possa rappresentare una soluzione terapeutica valida sia sotto il profilo economico sia sotto il profilo di efficacia.
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Standaert, B., A. Marocco, B. Assael, G. Gabutti, A. Guarino, P. L. Lopalco, Federico Marchetti et al. « Analisi di costo-efficacia della vaccinazione universale in Italia con il vaccino Rix4414 contro i rotavirus ». PharmacoEconomics Italian Research Articles 10, no 1 (mars 2008) : 23–35. http://dx.doi.org/10.1007/bf03320638.

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Dibidino, R., M. Ruggeri, M. Marchetti, N. Lombardi, M. Raffaelli, G. Attinà et A. Cicchetti. « Lo studio HARMONIC : valutazione costo-efficacia dell’uso del bisturi a ultrasuoni negli interventi di tiroidectomia totale ». PharmacoEconomics Italian Research Articles 12, no 3 (novembre 2010) : 143–55. http://dx.doi.org/10.1007/bf03320672.

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Palmer, A. J., L. Annemans, S. Roze, M. Lamotte, P. Berto, M. Ravera et R. A. Rodby. « Costo-efficacia di irbesartan in pazienti con diabete di tipo 2, ipertensione e nefropatia : prospettiva italiana ». PharmacoEconomics Italian Research Articles 7, no 1 (mars 2005) : 43–57. http://dx.doi.org/10.1007/bf03320534.

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Berto, P., A. Morsanutto, S. Lopatriello, M. Martelli, G. Muti, G. Santini et U. Vitolo. « Analisi costo-efficacia di rituximab + CHOP versus CHOP in soggetti affetti da linfoma non-Hodgkin aggressivo ». PharmacoEconomics Italian Research Articles 6, no 3 (novembre 2004) : 151–60. http://dx.doi.org/10.1007/bf03320633.

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Cicchetti, A., M. Ruggeri, A. Gasbarrini, A. Cazzato, G. Di Gioacchino, P. Navarra, R. Cauda et G. Romano. « Valutazione costo-efficacia del percorso dei pazienti a rischio di epatite B sottoposti a test anti-HBV ». PharmacoEconomics Italian Research Articles 11, no 2 (juillet 2009) : 105–19. http://dx.doi.org/10.1007/bf03320662.

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Gasparini, R., C. Lucioni, F. Ansaldi, P. Durando, L. Sticchi, G. Icardi, D. Panatto, M. Martin, J. Chancellor et S. Aballéa. « Studio costo-efficacia della vaccinazione influenzale per gli italiani di età compresa tra 50 e 64 anni ». PharmacoEconomics Italian Research Articles 9, no 2 (juillet 2007) : 91–101. http://dx.doi.org/10.1007/bf03320703.

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Baio, Gianluca, et Pierluigi Russo. « Un modello di analisi del valore dell’informazione per la valutazione di costo-efficacia nell’ambito del processo regolatorio ». PharmacoEconomics Italian Research Articles 12, no 1 (mars 2010) : 5–16. http://dx.doi.org/10.1007/bf03320526.

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Bonfantini, Bertrando. « Gli scarti possibili e necessari : il Rue come progetto strategico ». TERRITORIO, no 57 (juin 2011) : 70–75. http://dx.doi.org/10.3280/tr2011-057009.

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Il Regolamento urbanistico edilizio non č il luogo della regola banale, ma concorre alla costruzione del progetto strategico per la cittŕ. La sua natura ‘statutaria' lo rende particolarmente sensibile alla consuetudine localmente radicata, e questo crea una tensione tra inerzia ed innovazione in un processo dagli esiti incerti, ben oltre la mera approvazione formale. L'articolo propone quattro passaggi: evidenzia il ruolo di snodo assunto dal Rue in rapporto al Psc e al Poc, ma soprattutto con i regolamenti di settore e complementi normativi di cui tenta il coordinamento; sottolinea come il Rue configuri un ‘palinsesto', nel complesso equilibrio tra regole che restano e regole nuove; si sofferma sui principali scostamenti che marcano lo scarto rispetto al passato; sostiene l'urgenza di una rinnovata efficacia del regolamento anche a costo di una temporanea minore efficienza.
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Zaniolo, Orietta, Lorenzo Pradelli et Mario Eandi. « Costo/efficacia della prevenzione di infezioni alle prime vie aeree mediante un estratto batterico immunostimolante aspecifico (OM-85) ». Farmeconomia. Health economics and therapeutic pathways 6, no 3 (15 septembre 2005) : 169–84. http://dx.doi.org/10.7175/fe.v6i3.833.

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OBJECTIVES: 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.
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Stanisic, Sanja, Americo Cicchetti, Camillo Porta, Giuseppe Procopio et Patrizia Berto. « Costo-Efficacia di cabozantinib nel trattamento di seconda linea del tumore a cellule renali metastatico (mRCC) in Italia ». Global & ; Regional Health Technology Assessment : Italian ; Northern Europe and Spanish 2018 (janvier 2018) : 228424031879073. http://dx.doi.org/10.1177/2284240318790734.

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Lazzaro, C., P. Ruffo et M. Gozzo. « Analisi costo-efficacia dell’associazione budesonide/formoterolo come terapia di mantenimento e “al bisogno” nella gestione dell’asma. Valutazione italiana ». PharmacoEconomics Italian Research Articles 11, no 1 (mars 2009) : 39–53. http://dx.doi.org/10.1007/bf03320656.

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Marchettini, Paolo, Lisa Da Deppo et Lorenzo Pradelli. « Pregabalin versus gabapentin nel trattamento dei pazienti con neuropatia periferica : adattamento di un modello internazionale per la valutazione di costo/efficacia e costo/utilità alla realtà nazionale ». Farmeconomia. Health economics and therapeutic pathways 6, no 3 (15 septembre 2005) : 243–50. http://dx.doi.org/10.7175/fe.v6i3.838.

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OBJECTIVE: To compare the economic impact of treating neuropathic pain with pregabalin versus gabapentin. DESIGN: A cost effectiveness analysis comparing costs and effects of pregabalin 375 mg/die versus gabapentin 1800 mg/die in the perspective of the Italian National Healthcare Service was developed. The cost effectiveness analysis is examined alternatively in terms of the incremental cost per additional day with no or mild pain, and the incremental cost per quality-adjusted life-year (QALY) gained. Effects were derived from a pregabalin randomised clinical study 1008-155 and gabapentin 645-210 and 945-211 studies. Effects are expressed as reduction score of the VAS pain scale. Pharmacological costs were quantified according to the Italian market price of the drugs; healthcare procedure and hospitalisation costs were quantified on the basis of the National Tariff. Other healthcare services consumption data were derived from a Delphi Panel. To estimate the impact of pregabalin and gabapentin on daily pain experience in patients with neuropatic pain a Markov model is used. The dynamic simulation focuses on a hypothetical cohort of 1000 patients and simulates their daily pain experience over 12 weeks, to estimate clinical and economic outcomes for the group as a whole. MAIN OUTCOME MEASURES AND RESULTS: The cost-effectiveness ratio for the use of pregabalin is less than 1 euro per additional day with no or mild pain and 468 euros per QALY. The sensitivity analysis conducted to examine the effects of decreasing gabapentin dose to 1200 mg/die showes the consistency of the model results. CONCLUSIONS AND RESULTS: Although pregabalin pure costs are higher than gabapentin costs, the analyses prove pregabalin to be more effective with a small additional cost per day with no or mild pain.
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Olivares, Josè M., Alfonso Rodriguez-Martinez, Josè A. Buron, David Alonso-Escolano et Alexander Rodriguez-Morales. « Analisi costo-efficacia dello switch da un trattamento antipsicotico a risperidone iniettabile a rilascio prolungato in pazienti con schizofrenia ». Giornale Italiano di Health Technology Assessment 1, no 1 (janvier 2008) : 39–48. http://dx.doi.org/10.1007/bf03320712.

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Oliveri, C., F. Polcaro et R. Ravasio. « Analisi economica di exenatide rispetto a liraglutide nei pazienti con diabete di tipo 2 : costo-efficacia e budget impact ». Giornale Italiano di Health Technology Assessment 3, no 2 (septembre 2010) : 73–79. http://dx.doi.org/10.1007/bf03320735.

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Berto, Patrizia, S. Lopatriello, L. Arcaini, G. Del Poeta, M. Martelli, L. Gargantini et U. Vitolo. « Costo-efficacia di rituximab nella terapia di mantenimento in soggetti affetti da linfoma non-Hodgkin follicolare refrattario o recidivante ». PharmacoEconomics Italian Research Articles 9, no 1 (janvier 2007) : 9–19. http://dx.doi.org/10.1007/bf03320566.

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Lucioni, Carlo, S. Mazzi et K. Neeser. « Analisi di costo-efficacia della terapia combinata con pioglitazone nel trattamento del diabete mellito di tipo 2 in Italia ». PharmacoEconomics Italian Research Articles 6, no 2 (juillet 2004) : 81–93. http://dx.doi.org/10.1007/bf03320626.

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Liguori, Gerardo, et Vincenzo De Paola. « Riorganizzazione dell’attività chirurgica per setting assistenziali e complessità di cura ». La Sanità Pubblica. Ricerca applicata 2, no 2 (25 juillet 2021) : 69–82. http://dx.doi.org/10.48268/chirurgia/2021/0001.1.

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Il Ministero della Salute svolge attività di supporto e collaborazione con le Regioni per migliorare sia i livelli di efficienza e di produttività che quelli di appropriatezza, sicurezza ed efficacia delle cure ospedaliere (D.M. 70/2015, Legge di Stabilità 2016 e D.M.21 giugno 2016). A tal fine ha attivato il progetto “Riorganizzazione dell’attività chirurgica per setting assistenziali e complessità di cura” di durata triennale, allo scopo di mettere a disposizione conoscenze e competenze messe a punto in altre realtà sanitarie nazionali. L’implementazione di tali Best Practices, finalizzata a migliorare la gestione dei blocchi operatori, risulta strategica nel contesto nazionale, data la necessità di affinare gli strumenti per misurare le performance delle strutture ospedaliere a maggior complessità, in particolare per quelle attività di alto livello ed elevato costo come l’attività chirurgica. A questo progetto Ministeriale la Regione Campania ha aderito, proponendo come Aziende Pilota l’Azienda Ospedaliera Cardarelli di Napoli e l’Azienda Ospedaliera Universitaria S. Giovanni di Dio e Ruggi d’Aragona di Salerno.
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Eandi, Mario. « Costruzione di un modello decisionale per valutare la costo/efficacia delle strategie alternative nella terapia della polmonite acquisita in comunità ». Farmeconomia. Health economics and therapeutic pathways 2, no 1 (15 mars 2001) : 37–61. http://dx.doi.org/10.7175/fe.v2i1.720.

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Aim 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.
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Ravasio, Roberto, N. Giotta, A. Marino, M. Colombo, F. Caligaris, G. Cesano, A. Grill, D. Sassone et E. Biamino. « Analisi costo-efficacia di cinacalcet più terapia standard versus terapia standard nel trattamento dei pazienti in dialisi con iperparatiroidismo secondario ». PharmacoEconomics Italian Research Articles 10, no 1 (mars 2008) : 13–22. http://dx.doi.org/10.1007/bf03320637.

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Ravasio, Roberto. « Analisi di costo efficacia di trastuzumab nel trattamento adiuvante del carcinoma mammario precoce HER-2 positivo : l’esperienza della Regione Toscana ». Giornale Italiano di Health Technology Assessment 2, no 3 (septembre 2009) : 89–98. http://dx.doi.org/10.1007/bf03320724.

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Ravasio, Roberto, C. Lucioni et G. Chirico. « Costo-efficacia di palivizumab versus non profilassi nella prevenzione delle infezioni da VRS nei bambini pretermine, a diversa età gestazionale ». PharmacoEconomics Italian Research Articles 8, no 2 (juillet 2006) : 105–17. http://dx.doi.org/10.1007/bf03320561.

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Leveni, Daniela, Damiano Mazzoleni et Daniele Piacentini. « Cognitive-behavioural group treatment of panic attacks disorder : a description of the results obtained in a public mental health service ». Epidemiology and Psychiatric Sciences 8, no 4 (décembre 1999) : 270–75. http://dx.doi.org/10.1017/s1121189x00008186.

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RIASSUNTOScopo - In questo lavoro vengono presentati i risultati, a breve termine e dopo sei mesi di follow-up, ottenuti con un trattamento intensivo di tipo cognitivo-comportamentale di gruppo in soggetti affetti da Disturbo da Attacchi di Panico con o senza Agorafobia secondo i criteri del DSM IV. Disegno e Setting - I risultati si riferiscono ad un campione di 22 soggetti trattati presso il Centro Psico Sociale di Zogno (BG) e valutati attraverso strumenti obiettivi di autovalutazione, inerenti sia la soddisfazione di vita (SF/36) che l'and amento sintomatologico (PAAAS, MSPS, STAI-X1, STAI-X2). I dati ottenuti sono indicativi di significativi miglioramenti al termine del trattamento. Sono in corso ulteriori follow-up per valutare il mantenimento nel tempo dei risultati raggiunti. Conclusioni -Il risultato più importante appare comunque la dimostrazione che anche in un Servizio pubblico italiano di salute mentale, come in molti paesi esteri, è stato possibile trattare pazienti affetti da Disturbi d'Ansia con tecniche di dimostrata efficacia e relativamente a basso costo e soprattutto che è possibile introdurre nell'attività clinica routinaria indicatori obiettivi di esito.
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Marchetti, Monia, et Giorgio Lorenzo Colombo. « Considerazioni cliniche ed economiche nel trattamento del cancro della prostata : analisi costo-efficacia di bicalutamide vs flutamide in combinazione con LHRH ». Farmeconomia. Health economics and therapeutic pathways 4, no 3 (15 septembre 2003) : 153–68. http://dx.doi.org/10.7175/fe.v4i3.776.

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Prostate carcinoma (PC) is the most common malign neoplasm found in men over 65 years of age. In Italy, the incidence of this cancer is around 60/100,000/year, corresponding to about 11,000 new cases each year. Patients with PC consume health resources for a cost that is 10-24% higher than that of similar populations without PC. It is estimated that in Italy, each year, there are 19,000 hospitalizations for prostate cancer in patients over 65, a figure that represents 4% of the total hospitalizations for oncological diseases. We conducted a marginal cost/effectiveness analysis of bicalutamide vs. flutamide, both administered in combination with LHRH, in patients with advanced (metastatic) PC, on the basis of a randomized trial comparing 4 strategies of total androgenic blockade (TAB). The analysis was conducted in the perspective of the SSN (National health system). The comparison revealed that drug acquisition costs are not the only determinants of the economical differences between the two therapeutical strategies. Furthermore, we demonstrated that prolonged survival of the patients does not increase the consumption of health resources, since the chronological shift of the terminal phase reduces the value of the resources dedicated to it. When conducing the cost/effectiveness analysis, the survival advantage associated to bicalutamide has been adjusted to balance the low quality of life of PC patients. The pharmacoeconomical benefit of bicalutamide resulted of 12,150 Euro/QALY, while the cost per year of life saved resulted inferior, ranging from 8.327 to 11.440 Euro. This cost/QALY value is nevertheless lower than that associated to several therapeutical strategies that are commonly accepted in developed countries (domiciliar hemodialysis, heart transplantation, breast cancer screening, etc.). Considering that 12.150 Euro/QALY is the highest estimate of the relative cost/effectiveness of bicalutamide, it appears that the combination bicalutamide + LHRH represents an economically acceptable alternative to flutamide + LHRH in advanced PC patients.
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Iannazzo, Sergio, Lorenzo Pradelli et Mario Eandi. « Sviluppo e implementazione di un modello farmacoeconomico per valutare la costo efficacia di un ACE-inibitore nella prevenzione del rischio cardiovascolare ». Farmeconomia. Health economics and therapeutic pathways 4, no 3 (15 septembre 2003) : 169–79. http://dx.doi.org/10.7175/fe.v4i3.777.

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Cardiovascular disease (CVD) remains one of the leading causes of mortality and morbidity worldwide. Since several pharmacological approaches are available for the reduction of incidence and severity of cardiovascular events and health resources in modern managed care systems are limited, the evaluation of the clinical and economical consequences of any treatment is very valuable for decison-makers and physicians. In this article we present a flexible pharmacoeconomic model that permits the calculation of the marginal costeffectiveness of cardiovascular prevention with ramipril, a drug of the class of ACE-inhibitors. The clinical data used for the modelization are derived from the HOPE (Heart Outcomes Prevention Evaluation) study, a landmark cardiovascular prevention study that showed how the benefits of ACE-inhibition with ramipril go beyond the effects on blood pressure, while Italian epidemiological, demographic and economical data make the results appliable to the Italian population. The model, structured as a decision tree comparing the alternatives “to treat” or “not to treat” with Markow chains at the terminal nodes, calculates the marginal cost-effectiveness of the preventive treatment in terms of cost/year of live saved. The model is characterized by high flexibility, as it allows health decision-makers to set epidemiological and economical data in order to reflect the local population at high risk for developing cardiovascular diseas. The model was tested on a high risk population, formed by all acute myocardial infarction survivors in Italy, and indicated that life-long treatment of this patients would yield significant clinical benefits, with a cost/ effectiveness of 3,932 euro/year of life saved. This value is well below the standards that are considered acceptable, and offsprings from the partial offset of pharmaceutical costs caused by the reduction in the expenses for diagnosis and treatment of the cardiovascular events avoided with the preventive therapy.
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Eandi, Mario. « Analisi Costo-Efficacia di Amfotericina B Liposomiale (L-AmB) versus Amfotericina B Complesso Lipidico (ABLC) nel trattamento empirico della neutropenia febbrile ». Farmeconomia. Health economics and therapeutic pathways 6, no 4 (15 décembre 2005) : 333–47. http://dx.doi.org/10.7175/fe.v6i4.851.

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Current international guidelines for the management of immuno-compromised patients with febrile neutropenia recommend a systemic antimicrobial therapy if fever hasn’t receded after three days of antibiotic treatment. Amphotericin B remains the gold standard because of its broad spectrum fungicidal action and minimal resistance development risk. Nonetheless, therapeutic use of the standard formulation, Amphotericin B deoxycholate, is limited by its toxicity, especially on the kidneys. To counteract this, amphotericin B has been encapsulated in liposomes, a process which reduces its toxicity and allows higher doses to be given. Three lipid formulations have been developed and are now available in most countries: amB colloidal dispersion (ABCD), amB lipid complex (ABLC), and liposomal amB (L-AmB). These lipid formulations differ in pharmacodynamics and pharmacokinetics, and can’t therefore be considered interchangeable. Besides, they are more expensive than Amphotericin B deoxycholate. Aim of the study is to perform a cost/effectiveness analysis (CEA) comparing L-AmB (3mg/kg/die or 5mg/kg/ die) and ABLC (5mg/kg/die) as first-line antimicrobial empirical treatments in immuno-compromised patients with febrile neutropenia resistant to broad spectrum antibiotics. Secondly, we present a cost-minimization analysis (CMA) of the considered alternatives, assuming the same efficacy for all treatments. At the end we value the principal cost items from the point of view of the Italian Health Service, with a particular focus on the economic burden caused by adverse reactions.
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Rebesco, Barbara, Elena Cantagalli et Maria Elvira Amalfitano. « Analisi costo-efficacia di due schemi adiuvanti per il trattamento del carcinoma del colon-retto : lettura dei dati dello studio mosaic ». Tumori Journal 91, no 6 (novembre 2005) : 1–10. http://dx.doi.org/10.1177/030089160509100628.

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Filippelli, Egidio, Giovanni Biricolti, Cinzia Scarano, Federico Russo et Lucio Luciano. « Il trattamento dei disturbi psicotici con olanzapina, risperidone e neurolettici tipici : una valutazione comparativa di costo/efficacia in una realtà psichiatrica locale ». Farmeconomia. Health economics and therapeutic pathways 6, no 3 (15 septembre 2005) : 161–68. http://dx.doi.org/10.7175/fe.v6i3.832.

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BACKGROUND: Several clinical trials demonstrated that atypical antipsychotics are more effective but also more expensive (as drug cost) compared with the typical neuroleptics by treating psychotic disorders. The present study aimed to evaluate this result using an observational approach which better reflects the real clinical practice. OBJECTIVE: To evaluate clinical effectiveness (including work and social functioning) and overall direct costs in a group of patients affected by psychotic disorders (schizophrenia and bipolar) and treated with typical and atypical (olanzapine and risperidone) antipsychotics. METHODS: With a multicentre observational design - two years long - 89 patients (in charge by Psychiatric Centers of Regione Campania - Italy) were assessed using CGI (Clinical Global Impression) and GAF (Global Assessment of Functioning) scales. Moreover economic data were collected with reference to pharmacological and non-pharmacological (hospitalization, medical/nurse visits, etc.) resources consumption. The pharmacoeconomic analysis were conducted choosing the perspective of the local Psychiatric Services for costs attribution. RESULTS: Considering the treatment outcomes, the use of the atypical drugs provided better performances with reference to the patients quality of life. The results in terms of work and social functioning indicated an advantage in the olanzapine group of patients. Overall direct costs of treatment (drugs and healthcare resources) didn’t generate significant differences among the groups of therapy despite the pharmacological cost evidentiated an economic advantage (p
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Ravasio, R., L. Sanfilippo, G. De Paoli, C. Cerra, P. Fratino et M. Della Giovanna. « Analisi di costo-efficacia dello switch da un antipsicotico orale a risperidone a rilascio prolungato nel trattamento dei pazienti affetti da schizofrenia ». Giornale Italiano di Health Technology Assessment 2, no 1 (mars 2009) : 1–8. http://dx.doi.org/10.1007/bf03320713.

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Ravasio, Roberto, P. Sacchi, L. Maiocchi, S. Patruno, R. Bruno et G. Filice. « Costo efficacia di peginterferone α-2a + ribavirina verso peginterferone α-2b + ribavirina nel trattamento dell’epatite cronica di tipo C in pazienti non pretrattati ». PharmacoEconomics Italian Research Articles 7, no 3 (novembre 2005) : 207–18. http://dx.doi.org/10.1007/bf03320551.

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Castorina, Sebastiano Maurizio. « Rettifica al lavoro : considerazione cliniche ed economiche nel trattamento del cancro della prostata : analisi costo/efficacia di bicalutamide vs. flutamide in combinazione con LHRH ». Farmeconomia. Health economics and therapeutic pathways 5, no 1 (15 mars 2004) : 31–32. http://dx.doi.org/10.7175/fe.v5i1.787.

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Ravasio, Roberto. « Costo efficacia di peginterferone α-2a + ribavirina versus peginterferone α-2b + ribavirina nel trattamento dell’epatite cronica di tipo C in pazienti HIV co-infetti ». PharmacoEconomics Italian Research Articles 10, no 1 (mars 2008) : 37–47. http://dx.doi.org/10.1007/bf03320639.

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Ravasio, R. « Analisi di costo-efficacia di exenatide versus insulina glargine nel trattamento dei pazienti diabetici di tipo 2 in fallimento secondario al doppio ipoglicemizzante orale ». Giornale Italiano di Health Technology Assessment 1, no 1 (janvier 2008) : 21–30. http://dx.doi.org/10.1007/bf03320710.

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Merli, F., Roberto Ravasio, I. Alvarez De Cielis et F. Polcaro. « Analisi di costo-efficacia di rituximab più CHOP versus ProMACE-CytaBOM nel trattamento del linfoma diffuso a grandi cellule B : l’esperienza di Reggio Emilia ». Giornale Italiano di Health Technology Assessment 2, no 2 (juin 2009) : 55–64. http://dx.doi.org/10.1007/bf03320719.

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