Analisi della spesa e dei rimborsi relativi ai farmaci ad elevato impatto economico nella Regione del Veneto. Anno 2016
Raffaella Blasi, Valentina Fantelli, Margherita Andretta, Giovanna Scroccaro
Introduction AIFA registers allow you to verify the prescriptive appropriateness and to analyze drug reimbursements with Managed Entry Agreements (MEAs). Once the process is completed, a refund request (RdR) is created followed by a payment proposal (PdP). Veneto Region uses Data Ware House (DWH) to monitor pharmaceutical spending. The aim of this paper is to compare Veneto’s 2016 expenditure with refunds on some anticancer drugs and new direct-acting antivirals (DAAs) for hepatitis C.
Materials and Methods PdP for anticancer drugs and new DAAs was analyzed through the Registers. Through DWH, total expenditure and oncology and DAAs were analyzed. Through a file sent to the prescription centers of the new DAAs, the paybacks for the price/volume agreement were requested.
Results Total spending in 2016 was 916 million euros. 94,000 euros have been spent on anticancer drugs reimbursed. PdPs incurred for oncology amount to 3% of total expenditure. The most reimbursed refunds concerned drugs for breast, prostate, ovarian, rectal and colon cancer. The most important MEAs concerned Cost Sharing and Payment by Result. Regarding the new DAAs, Veneto’s gross refunds were 126 million euros and net of 49 million, with paybacks of 77.4 million euros.
Conclusions The DWH and the AIFA Register are tools for economic evaluations and to know spending net of paybacks (low refunds for oncology but consistent for new DAAs). There are, however, critical issues such as the limited visibility of the information that constitutes an epidemiological heritage for our region.
Key words: MEAs: Managed Entry Agreements; RdR: refund request; PdP: payment proposal; DWH: Data Ware House; DAA: direct-acting antivirals