scholarly journals Valorization of clinical trials from the Italian National Health Service perspective: definition and first application of a model to estimate avoided costs

Author(s):  
Americo Cicchetti ◽  
Domenico Addesso ◽  
Filippo Elvino Leone ◽  
Antonino Amato ◽  
Luca Angerame ◽  
...  

Introduction: From the perspective of healthcare organizations and public health care systems, the value of a clinical trial can be assessed from a clinical and economical perspective. However, to date, there is no standardized model for systematically capturing the economic value of clinical trials at organizational and system levels. The aim of this study was to develop and test a methodology for estimating the avoided costs deriving from the management of patients as part of a clinical trial. Methods: Our methodology is based on the assumption that the economic value of a clinical trial derives from 1) the funding received by the experimental site from a trial’s sponsor, and from 2) the cost avoided by the experimental site with the treatment of patients within a study and not according to standard care by the experimental site.  Results: By applying the methodology to onco-hematological clinical trials conducted in two academic hospitals from 2011 to 2016, we demonstrate that savings between 2 million and 4 million euros were achieved over a five-year period. Thus, for every 1,000 euros invested by the pharmaceutical company into the clinical studies conducted at these hospitals, the hospitals saved on average 2,200 euros due to costs not incurred as a result of the trials. Conclusions: The study has proposed and tested a methodology for estimating the economic value of clinical trials by taking into account avoided costs deriving from the treatment of patients enrolled in sponsored trials. The study has proposed a management tool for healthcare institutions to govern clinical trials.

2001 ◽  
Vol 2 (4) ◽  
pp. 223-229
Author(s):  
Carlo Lucioni ◽  
Luca Zappaterra

At the beginning of this new millennium, when the request for health care exceeds overall economic growth, resorting to self-medication allows to free up healthcare resources and it has a positive outcome for public health care systems and also for the individual. Self-medication is defined as the application of prescription-free medicines (OTC) to consumers in order to cure minor ailments. Aim of this study is to present the social and economic value of self-medication, comparing the Italian situation with other national situations inside European Union, especially France, U.K. and Germany. In Italy the OTC market is still late and the present study examines the different explanations, considering the trade-off between OTC products and health public spending, the geographical distribution and the possible savings for the for public health care system.


Author(s):  
Pierre Pestieau ◽  
Mathieu Lefebvre

This chapter reviews the public health care systems as well as their challenges. It first shows how expenditure on health care has evolved in previous decades and deals with the reasons for the growth observed in almost every European country. It emphasizes the role of technological progress as a main explanatory factor of the increase in medical expenditure but also points to the challenges facing cost-containment policies. Especially, the main common features of health care systems in Europe, such as third-party payment, single provider approach and cost-based reimbursement are discussed. Finally the chapter shows that although inequalities in health exist in the population, health care systems are redistributive. Reforms are thus needed but the trade-off between budgetary efficiency and equity is difficult.


Author(s):  
Punidha Kaliaperumal ◽  
Tamorish Kole ◽  
Neha Chugh

ABSTRACT Health-care systems all over the world are stretched out and being reconfigured to deal with the coronavirus disease 2019 (COVID-19) pandemic. Some countries have flattened the curve, some are still fighting to survive it, and others are embracing the second wave. Globally, there is an urgent need to increase the resilience, capacity, and capability of health-care systems to deal with the current crisis and improve upon the future responses. The epidemiological burden of COVID-19 has led to rapid exhaustion of local response resources and massive disruption to the delivery of care in many countries. Health-care networking and liaison are essential component in disaster management and public health emergencies. It aims to provide logistical support between hospitals; financial support through local or regional governmental and nongovernmental agencies for response; manpower and mechanism for coordination and to implement policies, procedures, and technologies in the event of such crisis. This brief report describes how 4 independent private hospitals in northern India had adopted the principles of health-care networking, pooled their resources, and scaled up 1 of the partner hospitals as Dedicated COVID-19 Hospital (DCH) to treat moderate to severe category of COVID-19 patients. It brings out the importance of a unique coalition between private and public health-care system.


2020 ◽  
pp. 1357633X2094204
Author(s):  
Antonio Lopez-Villegas ◽  
Rafael Jesus Bautista-Mesa ◽  
Miguel Angel Baena-Lopez ◽  
Maria Luisa Alvarez-Moreno ◽  
Jesus E Montoro-Robles ◽  
...  

Introduction Asynchronous teledermatology (TD) has undergone exponential growth in the past decade, allowing better diagnosis. Moreover, it saves both cost and time and reduces the number of visits involving travel and opportunity cost of time spent on visits to the hospital. The present study performed a cost-saving analysis of TD units and assessed whether they offered a cheaper alternative to conventional monitoring (CM) in hospitals from the perspective of public health-care systems (PHS) and patients. Methods This study was a retrospective assessment of 7030 patients. A cost-saving analysis comparing TD units to CM for patients at the Hospital de Poniente was performed over a period of one year. The TD network covered the Hospital de Poniente reference area (Spain) linked to 37 primary care (PC) centres that belonged to the Poniente Health District of Almeria. Results We observed a significant cost saving for TD units compared to participants in the conventional follow-up group. From the perspective of a PHS, there was a cost saving of 31.68% in the TD group (€18.59 TD vs. €27.20 CM) during the follow-up period. The number of CM visits to the hospital reduced by 38.14%. From the patients’ perspective, the costs were lower, and the cost saving was 73.53% (€5.45 TD vs. €20.58 CM). Discussion The cost-saving analysis showed that the TD units appeared to be significantly cheaper compared to CM.


2017 ◽  
Vol 12 (4) ◽  
pp. 411-433 ◽  
Author(s):  
Christopher Newdick

AbstractHow does the concept of autonomy assist public responses to ‘lifestyle’ diseases? Autonomy is fundamental to bioethics, but its emphasis on self-determination and individuality hardly supports public health policies to eat and drink less and take more exercise. Autonomy rejects a ‘nanny’ state. Yet, the cost of non-communicable diseases is increasing to individuals personally and to public health systems generally. Health care systems are under mounting and unsustainable pressure. What is the proper responsibility of individuals, governments and corporate interests working within a global trading environment? When public health care resources are unlikely to increase, we cannot afford to be so diffident to the cost of avoidable diseases.


2014 ◽  
Vol 9 (3) ◽  
pp. 231-249 ◽  
Author(s):  
Federico Toth

AbstractThe Italian National Health Service began experimenting with a significant regionalisation process during the 1990s. The purpose of this article is to assess the effects that this regionalisation process is having on the rift between the north and the south of the country. Has the gap between the health care systems of the northern and southern regions been increasing or decreasing during the 1999–2009 decade? Three indicators will be utilised to answer this question: (1) the level of satisfaction expressed by the citizens towards the regional hospital system; (2) the mobility of the patients among regions; (3) the health care deficit accumulated by the individual regions. On the basis of these three indicators, there is evidence to conclude that, during the decade under study, the gap between the North and the South, already significant, has increased further.


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