Global & Regional Health Technology Assessment最新文献

{"title":"Survival, treatment duration and costs of patients with prostate cancer treated with triptorelin in Italy: a study of administrative databases.","authors":"Orazio Caffo, Gaetano Facchini, Luca Degli Esposti, Valentina Acciai, Giorgio Mauri, Paola Mazzanti, Giuseppe Fornarini","doi":"10.33393/grhta.2024.3055","DOIUrl":"https://doi.org/10.33393/grhta.2024.3055","url":null,"abstract":"<p><strong>Background: </strong>Several data support the efficacy/effectiveness, safety and favorable impact on quality of life of triptorelin treatment in patients with prostate cancer. However, little evidence is available concerning triptorelin use in the long term.</p><p><strong>Methods: </strong>We analyzed data on triptorelin treatment in patients with prostate cancer in an integrated Italian administrative database, covering around 6 million health-assisted subjects throughout the country. Patients with at least one prescription for triptorelin in the period 2010-2020 and with no evidence of metastasis were included and followed up until 2021. Overall survival (OS) and duration of treatment were analyzed using Kaplan-Meier curves, starting from the date of first prescription.</p><p><strong>Results: </strong>The cohort included a total of 3,411 patients (mean age: 76.8 ± 8.7 years), of whom 1,326 (38.9%) were treated with triptorelin only and 2,085 (61.1%) with triptorelin combined with an anti-androgen. Overall, 847 (24.8%) patients with prostate cancer died and 1,037 (30.4%) had a treatment switch during the follow-up period, and both the median OS and median duration of treatment were not reached in both groups. The mean annual total cost per patient was estimated as 5,574 €, with almost half of the costs related to medication expenses (2,737 €).</p><p><strong>Conclusions: </strong>We found a long survival and duration of triptorelin treatment in this population of Italian patients with prostate cancer. This study with a long follow-up period further highlights the usefulness of healthcare utilization databases to integrate results obtained from clinical studies with those from everyday clinical practice.</p>","PeriodicalId":12627,"journal":{"name":"Global & Regional Health Technology Assessment","volume":"11 ","pages":"207-213"},"PeriodicalIF":0.4,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Il burden economico e sociale della porpora trombotica trombocitopenica congenita (cTTP) in Italia.","authors":"Filippo Rumi, Michele Basile, Eugenio Di Brino, Agostino Fortunato, Debora Antonini","doi":"10.33393/grhta.2024.3147","DOIUrl":"https://doi.org/10.33393/grhta.2024.3147","url":null,"abstract":"","PeriodicalId":12627,"journal":{"name":"Global & Regional Health Technology Assessment","volume":"11 ","pages":"200-206"},"PeriodicalIF":0.4,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug utilization and medication adherence for the treatment of psoriatic arthritis: an Italian study.","authors":"Fiorenzo Santoleri, Paolo Abrate, Laura Pestrin, Enrico Pasut, Germana Modesti, Felice Musicco, Chiara Fulgenzio, Eva Zuzolo, Gabriella Pieri, Martina Roperti, Pietro Gazzola, Marco Gambera, Isabella Martignoni, Valentina Montresor, Francesca Guarino, Laura Grossi, Letizia Di Fabio, Cristina Roberti, Concetta Spoltore, Gabriella Tinari, Stefania De Rosa, Romina Giannini, Roberto Langella, Grazia Mingolla, Mariantonietta Piccoli, Alberto Costantini","doi":"10.33393/grhta.2024.3204","DOIUrl":"https://doi.org/10.33393/grhta.2024.3204","url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to evaluate the persistence, treatment adherence and drug cost associated with biologic and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) in the management of psoriatic arthritis (PsA) in Italy, with a focus on biosimilar drugs.</p><p><strong>Methods: </strong>This was a retrospective observational study involving eight hospital pharmacies, between January 2017 and December 2020, on naïve patients with at least one b/tsDMARD dispensation indicated for PsA. Patients were followed up for 12 months and persistence and adherence were evaluated by proportion of days covered (PDC). The originator and biosimilar for adalimumab and etanercept were compared. Furthermore, the real annual cost per patient based on adherence to therapy was calculated.</p><p><strong>Results: </strong>Patients initiating b/tsDMARDs for PsA had a mean persistence of 263 days and 48.6% remained persistent for 1 year. Adherent patients (PDC ≥ 0.8) were 47.6% for the overall population. Similar persistence and adherence were observed between patients treated with the adalimumab originator and its biosimilar, while patients treated with the etanercept originator showed lower persistence and adherence compared to those treated with its biosimilar (mean persistence: 222 vs. 267 days, patient persistent at 1 year: 29.4% vs. 51.5%, mean PDC: 0.53 vs. 0.70, adherent patients: 23.5% vs. 51.5%). The average annual drug cost ranged from €8,724 (etanercept) to €14,783 (ustekinumab), with an annual saving of more than €2,500 by using biosimilars.</p><p><strong>Conclusion: </strong>Poor adherence to medications contributes to suboptimal clinical outcomes. The comparison between biosimilar and originator offers further evidence in support of the biosimilar to optimizing resources in healthcare.</p>","PeriodicalId":12627,"journal":{"name":"Global & Regional Health Technology Assessment","volume":"11 ","pages":"191-199"},"PeriodicalIF":0.4,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11467683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142462935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analisi di impatto sul budget sanitario italiano di roxadustat per il trattamento dell’anemia da malattia renale cronica.","authors":"Chiara Bini, Andrea Marcellusi, Paolo Di Rienzo, Lucia Del Vecchio","doi":"10.33393/grhta.2024.3062","DOIUrl":"https://doi.org/10.33393/grhta.2024.3062","url":null,"abstract":"","PeriodicalId":12627,"journal":{"name":"Global & Regional Health Technology Assessment","volume":"11 ","pages":"175-190"},"PeriodicalIF":0.4,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11393551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142284190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The efficacy of dalbavancin and impact on hospitalization and treatment costs in patients with ABSSSI.","authors":"Sergio Carbonara","doi":"10.33393/grhta.2024.3045","DOIUrl":"10.33393/grhta.2024.3045","url":null,"abstract":"<p><p>Acute bacterial skin and skin structure infections (ABSSSIs) represent a common and costly healthcare burden, accounting for millions of annual infections and billions of dollars in healthcare expenditures. Dalbavancin is a long-acting glycopeptide antibiotic that has demonstrated efficacy and safety in the treatment of ABSSSIs. This review article will examine the efficacy of dalbavancin and focus on its impact on the hospital length of stay and costs associated with management of these infections.</p>","PeriodicalId":12627,"journal":{"name":"Global & Regional Health Technology Assessment","volume":"11 Suppl 2","pages":"13-17"},"PeriodicalIF":0.4,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11292618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Usefulness of dalbavancin in early discharge and nonhospitalization. It's time to throw your heart over the obstacle?","authors":"Massimo Crapis, Sergio Venturini, Astrid Callegari, Giovanni Del Fabro, Igor Bramuzzo, Laura De Santi, Elisa Pontoni, Maurizio Tonizzo, Barbara Basso","doi":"10.33393/grhta.2024.3071","DOIUrl":"10.33393/grhta.2024.3071","url":null,"abstract":"<p><strong>Introduction: </strong>Dalbavancin is a semisynthetic lipoglycopeptide long-acting antibiotic approved for the treatment of acute bacterial skin and skin structure infections (ABSSSIs). Its features can be useful in the current healthcare scenario characterized by the shortage of available hospital beds.</p><p><strong>Materials methods and results: </strong>We implemented several actions in order to optimize the use of dalbavancin allowing an improvement strategy both from the healthcare system and the patient's perspective in two hospital settings. In the Emergency Department we hospitalized only patients who met the clinical criteria and not the logistic criteria (i.e., the need for antibiotic therapy infusion). During the years 2017-2023, this strategy was applied in 40 cases, thus avoiding 40 hospitalizations for a total saving of 280 days of hospitalization.In the Internal Medicine ward and surgery department when there was no longer any need for hospitalization, we discharged the patient as early as possible. During the years 2017-2023, this strategy was applied in 189 cases, saving at least 1,134 days of hospitalization. The outcome of the treated patients was favorable in 228 out of 229 patients (99.5%).</p><p><strong>Conclusions: </strong>Our experience using dalbavancin in ABSSSI has been very satisfactory overall. The efficacy was close to 100%. Minor adverse events of slight severity occurred rarely. At the same time, this strategy allowed a more efficient allocation of hospital beds. Dalbavancin presents an ideal pharmacodynamic/pharmacokinetic profile for the management of ABSSSI especially in settings where shortage of hospital beds is critical.</p>","PeriodicalId":12627,"journal":{"name":"Global & Regional Health Technology Assessment","volume":"11 Suppl 2","pages":"18-21"},"PeriodicalIF":0.4,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11292616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical, organizational, and pharmacoeconomic perspectives of dalbavancin vs standard of care in the infectious disease network.","authors":"Daniela Segala, Marco Barbieri, Mariachiara Di Nuzzo, Melissa Benazzi, Aurora Bonazza, Letizia Romanini, Brunella Quarta, Kristian Scolz, Anna Marra, Diana Campioni, Rosario Cultrera","doi":"10.33393/grhta.2024.3094","DOIUrl":"10.33393/grhta.2024.3094","url":null,"abstract":"<p><strong>Introduction: </strong>The therapeutic approach to the patient with acute bacterial skin and skin structure infection (ABSSSI) and complicated infections often involves the early transition from intravenous to oral therapy (early switch) or early discharge. Our study aimed to evaluate sustainable and innovative care models that can be transferred to community healthcare and the economic impact of dalbavancin therapy vs Standard of Care (SoC) therapy for the treatment of ABSSSI and other Gram-positive infections including those by multidrug-resistant organisms. We also described the organization of an infectious disease network that allows optimizing the treatment of ABSSSI and other complex infections with dalbavancin.</p><p><strong>Materials and methods: </strong>We retrospectively studied all patients treated with dalbavancin in the University Hospital \"S. Anna\" of Ferrara, Italy, between November 2016 and December 2022. The clinical information of each patient was collected from the hospital's SAP database and used to evaluate the impact of dalbavancin in early discharge with reduction of length of stay promoting dehospitalization and in improving adherence to antibiotic therapy.</p><p><strong>Results: </strong>A total of 287 patients (165 males and 122 females) were included in the study of which 62 were treated with dalbavancin. In 13/62 patients dalbavancin was administered in a single dose at the completion of therapy to facilitate early discharge. Assuming a 12-day hospitalization required for the treatment of ABSSSI or to complete the treatment of osteomyelitis or spondilodiscitis, the treatment with dalbavancin results in a cost reduction of more than €3,200 per single patient compared to SoC (dancomycin, linezolid or vancomycin).</p><p><strong>Conclusions: </strong>Dalbavancin has proven to be a valid therapeutic aid in the organization of a territorial infectious disease network given its prolonged action, which allows the dehospitalization with management of even patients with complex infections in outpatient parenteral antimicrobial therapy.</p>","PeriodicalId":12627,"journal":{"name":"Global & Regional Health Technology Assessment","volume":"11 Suppl 2","pages":"5-12"},"PeriodicalIF":0.4,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11292617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141891550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Place in therapy of dalbavancin to treat Gram-positive infections in antimicrobial resistance era: an overview.","authors":"Rosario Cultrera","doi":"10.33393/grhta.2024.3108","DOIUrl":"10.33393/grhta.2024.3108","url":null,"abstract":"","PeriodicalId":12627,"journal":{"name":"Global & Regional Health Technology Assessment","volume":"11 Suppl 2","pages":"1-4"},"PeriodicalIF":0.4,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11292619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Models of care and relevance of territorial management in assisting persons with epilepsy.","authors":"Oriano Mecarelli","doi":"10.33393/grhta.2024.2889","DOIUrl":"10.33393/grhta.2024.2889","url":null,"abstract":"<p><p>Epilepsy is a widespread social disease that affects people of all ages and often involves both diagnostic and therapeutic difficulties. Beyond seizure control, it is necessary to ensure people with epilepsy a good quality of life and respect for human rights, seeking to increase self-management capacity and break down stigma. People with epilepsy should have privileged access to specialized epilepsy centers, where multidisciplinary care is possible. These centers, organized by different levels of complexity, should be uniformly distributed throughout the country and networked together. The scientific community and health care organizations must therefore design all necessary strategies so that knowledge about epilepsy improves among the general population and the most effective pathways of care are effectively implemented.</p>","PeriodicalId":12627,"journal":{"name":"Global & Regional Health Technology Assessment","volume":"11 Suppl 1","pages":"2-7"},"PeriodicalIF":0.4,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11270230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141787793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of the hospital pharmacist to guarantee access and continuity of care for the management of epilepsy.","authors":"Marcello Pani","doi":"10.33393/grhta.2024.2970","DOIUrl":"10.33393/grhta.2024.2970","url":null,"abstract":"<p><p>In this article the pivotal role of hospital pharmacists in the multidisciplinary management of epilepsy is discussed. Hospital pharmacists are members of national and local ethics committees, oversee clinical trials, and ensure adherence to regulations for patient access to novel therapeutic treatments. They actively contribute to regulatory processes and the definition of prescribing centers. In the post-launch phase, hospital pharmacists are a key member in the multidisciplinary team, they are involved in decisions relating to the local introduction of drugs, in the management of the drug within the hospital structure and with the direct distribution, and to ensure proper and timely treatment. The pharmacovigilance network, including hospital and community pharmacists, monitors and prevents adverse effects related to epilepsy medications and enhances a collaborative approach with specialists to promote prescription appropriateness, targeting therapy for better patient outcomes. Finally, the potential benefits of deprescribing are briefly discussed, underscoring the importance of a multidisciplinary approach involving doctors and clinical pharmacists to gather comprehensive data and enhance patient care in epilepsy management.</p>","PeriodicalId":12627,"journal":{"name":"Global & Regional Health Technology Assessment","volume":"11 Suppl 1","pages":"8-10"},"PeriodicalIF":0.4,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11270225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141787794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}