L’utilizzo di modelli decisionali per le valutazioni economiche dei farmaci in Italia: stato dell’arte e prospettive future

Abstract

To appraise the methodological quality of the Italian pharmacoeconomic models. In most of the developed countries the institution of HTA agencies has been one of the major concerns in order to support the decisions for reimbursement of new drugs. Italy is experiencing a remarkable lack in this field. 18 Italian models published between 1998 and 2005 selected using EMBASE and MEDLINE search engines. Inclusion criteria: (a) Italian nationality of the first author, (b) Italian baseline population. Studies were appraised using the checklist developed by Philips et al. (2004). Although the alternatives and the basic framework of the pharmacoeconomic models are usually well defined and specified, the studies present a lack of data about treatment effects, utilities, analysis of uncertainty, considerations about heterogeneity and generalisability of results. Despite the high level of competence of the authors, the pharmacoeconomic models quality is largely affected by the scarce interest of Italian institutions for the use of ICER-based criteria, in favour of a price-minimization one. The institutional use of ICER-based criteria should be strongly recommended for a rational resource use in healthcare.