Hospital Pharmacy of the Santa Maria Hospital of Camerino, Camerino, Italy.
Experimental Medicine and Public Health Department, University of Camerino, Camerino, Italy.
Eur J Hosp Pharm. 2020 Mar;27(2):100-102. doi: 10.1136/ejhpharm-2018-001660. Epub 2018 Oct 24.
Pulmonary arterial hypertension is a rare and progressive respiratory disease characterised by high blood pressure and vascular resistance producing right ventricular fatigue. In Italy, pulmonary hypertension can be treated with different drugs available on the market at different costs, and in the Marche region distributed exclusively by hospital pharmacies. The present study examined in an area of the Marche region the use of drugs specifically indicated for pulmonary hypertension, and evaluated how the introduction of the generic bosentan might lower pharmaceutical costs for the healthcare budget.
The study examined oral administration prescriptions and costs using data from the Apotheke Gold (Record Data) database from 1 January 2012 to 31 August 2017.
Annually (from 1 January 2012 to 31 August 2017), an average of 4.83 patients were treated (prevalence of 102.35 cases per 1 million residents) with ambrisentan (Volibris), bosentan (Tracleer), macitentan (Opsumit), tadalafil (Adcirca) or sildenafil (Revatio). The total expenditure during the 5-year 8-month period was €472 405. Ambrisentan was by far the most expensive product overall, with a total expenditure of €222 380 for the period studied (a daily cost of €67.39), even though Tracleer had the highest cost for a day of treatment (a daily cost of €94.48, but a total expenditure of €163 976 for the period, due to its more recent marketing). Providing patients with the generic form bosentan in place of Tracleer would lower the costs dramatically. A very significant annual savings per patient of approximately €31 879 would be achieved, a striking 92.4% reduction in costs.
The prevalence of pulmonary arterial hypertension reported for Camerino and its surrounding area in the Marches region is quite high compared with that reported by other authors for France and Scotland. The introduction of the generic bosentan would cut costs drastically. It is to be hoped that centralised procurement at the regional level would bring further savings.
肺动脉高压是一种罕见的进行性呼吸系统疾病，其特征为血压高和血管阻力大，导致右心室疲劳。在意大利，肺动脉高压可采用市场上不同药物进行治疗，这些药物的成本也不同，在马尔凯地区仅由医院药房分发。本研究在马尔凯地区的一个区域内检查了专门用于肺动脉高压的药物的使用情况，并评估了通用波生坦的引入如何降低医疗保健预算的药物成本。
本研究使用 Apotheke Gold（记录数据）数据库从 2012 年 1 月 1 日至 2017 年 8 月 31 日的数据，研究了口服药物的处方和费用。
从 2012 年 1 月 1 日至 2017 年 8 月 31 日，每年（平均）有 4.83 名患者接受治疗（每 100 万居民中有 102.35 例），使用安贝生坦（Volibris）、波生坦（Tracleer）、马西替坦（Opsumit）、他达拉非（Adcirca）或西地那非（Revatio）。在 5 年 8 个月期间的总支出为 472405 欧元。安贝生坦是迄今为止总体上最昂贵的产品，在研究期间的总支出为 222380 欧元（每天 67.39 欧元），尽管 Tracleer 的治疗日费用最高（每天 94.48 欧元，但由于其较新的市场推广，期间的总支出为 163976 欧元）。为患者提供通用形式的波生坦替代 Tracleer 将大大降低成本。每位患者每年可节省约 31879 欧元，成本降低了 92.4%。
与法国和苏格兰的其他作者报告的结果相比，马尔凯地区卡梅里诺及其周边地区报告的肺动脉高压患病率相当高。引入通用波生坦将大幅降低成本。希望区域一级的集中采购将带来进一步的节省。
