Introduction: The introduction of biologic therapy has dramatically changed the management of patients with rheumatic, gastrointestinal and dermatological diseases, allowing to address and resolve medical conditions through a change of the natural history of these diseases.
Inhibitors of TNF-α are among the most widely used drugs in inflammatory diseases, for crucial role played by this cytokine in the pathogenesis of inflammation and joint damage.
Drug efficacy, safety and economic analysis have a significant impact on the effective use of biologic agents in daily clinical practice. Objective of our study was to evaluate the use of biologics in these diseases in the years 2012-2013 by querying the administrative database of the San Giuseppe Moscati Hospital.
Methods: This selected cohort study was based on the analysis of the database containing prescription drugs dispensed directly to the patient that discharged or outpatient care, using File F, evaluated the number of naïve patients for biological therapy and made an estimate of the costs.
Results: Since 2012-2013 there has been a net increasing percentage in the number of naïve patients accessing the biological therapy at the operating units of Internal Medicine and Gastroenterology represented respectively 69,3% and 93,75%.
The economic burden of biological therapy on total expenditure in the analyzed departments reached about 90% and medications that affected more significantly are Infliximab, Abatacept and Rituximab for Internal Medicine and Infliximab for Gastroenterology.
In the period 2012-2013 patients who did not respond to the first treatment and therefore switched to another biological therapy accounted less than 2% of the population evaluated.
Conclusions: Our data confirm the progressive increase of the patients treated with biological therapies. The undisputed advantages of biologic therapy are associated with an important economic impact on the Health System. In the Campania Region transposition of legislation that aims to monitor the appropriateness of prescribing criteria may represent an effective strategy to contain spending Health.

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Key words: biologic therapy, anti-TNFα, naïve patients, inflammatory disease, spending Health