Display options
Cite
Moretti M, Paleari L, Figallo F, et al. Italian Public Health Expenditure for Vitamin D is still high: New Outlook to Saving From a Consumption Analysis in the Liguria Region. Clin Ther. 2021;43(11):1969-1982doi: 10.1016/j.clinthera.2021.09.008.
Moretti, M., Paleari, L., Figallo, F., Garbarini, C., Ponti, E., Schena, F., & Marinelli, L. (2021). Italian Public Health Expenditure for Vitamin D is still high: New Outlook to Saving From a Consumption Analysis in the Liguria Region. Clinical therapeutics, 43(11), 1969-1982. https://doi.org/10.1016/j.clinthera.2021.09.008
Moretti, Michele, et al. "Italian Public Health Expenditure for Vitamin D is still high: New Outlook to Saving From a Consumption Analysis in the Liguria Region." Clinical therapeutics vol. 43,11 (2021): 1969-1982. doi: https://doi.org/10.1016/j.clinthera.2021.09.008
Moretti M, Paleari L, Figallo F, Garbarini C, Ponti E, Schena F, Marinelli L. Italian Public Health Expenditure for Vitamin D is still high: New Outlook to Saving From a Consumption Analysis in the Liguria Region. Clin Ther. 2021 Nov;43(11):1969-1982. doi: 10.1016/j.clinthera.2021.09.008. Epub 2021 Oct 28. PMID: 34756467.
Copy Download .nbib Format: NLM
Share it on

Clin Ther. 2021 Nov;43(11):1969-1982. doi: 10.1016/j.clinthera.2021.09.008. Epub 2021 Oct 28.

Italian Public Health Expenditure for Vitamin D is still high: New Outlook to Saving From a Consumption Analysis in the Liguria Region.

Clinical therapeutics

Michele Moretti, Laura Paleari, Fabrizio Figallo, Chiara Garbarini, Elisa Ponti, Francesca Schena, Lucio Marinelli

Affiliations

  1. SC Recupero e Rieducazione Funzionale - sede di Savona, Dipartimento di Cure Primarie, ASL 2 Sistema Sanitario Regione Liguria, Savona, Italy.
  2. A.Li.Sa. Liguria Health Authority, Genova, Italy. Electronic address: [email protected].
  3. Direzione Amministrativa, U.O. Bilancio e Programmazione Finanziaria, IRCCS Ospedale Policlinico San Martino, Genova, Italy. Electronic address: [email protected].
  4. SC Assistenza Farmaceutica Territoriale, ASL 3, Genova, Italy. Electronic address: [email protected].
  5. U.O. Bilancio e flussi finanziari, Area dipartimentale economica e gestionale, AUSL della Romagna, Ravenna, Italy. Electronic address: [email protected].
  6. IRCCS Istituto Giannina Gaslini, Genova, Italy. Electronic address: [email protected].
  7. Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genova, Italy; Division of Clinical Neurophysiology and Epilepsy Center, Department of Neuroscience, IRCCS Ospedale Policlinico San Martino, Genova, Italy. Electronic address: [email protected].

PMID: 34756467 DOI: 10.1016/j.clinthera.2021.09.008

Abstract

PURPOSE: Italian expenditure for vitamin D greatly increased in the last few years, reaching €314 million ($376.8 million) in 2019. In Italy, the main cause of the increase in public spending for vitamin D is the marketing of high-cost medicines. At national and regional levels, some interventions have been performed to reduce expenditure, but spending has continued to increase. The aim of this work is to propose a new saving strategy determined by an analysis of a significant sample of the market.

METHODS: Data on the use of vitamin D formulations, including data for the different active substances that represent its pharmaceutical analogue and composition of groups of equivalence, were extrapolated from the Italian Medicines Agency transparency lists and from the Farmadati database. Data on pharmaceutical expenditure were obtained from the Data Warehouse of Liguria Region; the composition of this expenditure was analyzed in detail, focusing on the characteristics of the pharmaceutical preparations and their cost (price per defined daily dose).

FINDINGS: Vitamin D expenditure paralleled that of cholecalciferol, the most used active ingredient, which in Liguria increased from €643,352 ($772,022.4) in 2010 to €8,006,574 ($9,607,888.8) in 2019 (increase of 1144%). Spending focused on high-cost formulations, exceeding 90% of total cholecalciferol cost in 2019. We simulated a possible optimization of the expense for cholecalciferol by applying a revised price to all the cholecalciferol consumptions in high-cost products because these formulations do not have an added therapeutic value, finding that the saving would be at least 60%. National data on the detailed expenditure composition for vitamin D are not available, but we found a strong resemblance between total cholecalciferol expenditure time series in Italy and the Liguria Region.

IMPLICATIONS: The expense of cholecalciferol and consequently the expense of vitamin D could be optimized by modifying the reimbursement of high-cost formulations. At a national level, savings should be proportional to that estimated for the Liguria Region. On the basis of the 2019 data, Italian savings with respect to total cholecalciferol expenditure should be €170.65 million ($204.78 million); per capita cholecalciferol expenditure would shift from €4.66 ($5.59) to €1.84 ($2.21).

Copyright © 2021 Elsevier Inc. All rights reserved.

Keywords: Liguria Region; cholecalciferol; health expenditure; high-cost formulations; vitamin D

Publication Types