Oncological Pharmacy Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori" IRST s.r.l., via Piero Maroncelli 40, 47014 Meldola, Italy.
Budget and Planning Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori" IRST s.r.l., via Piero Maroncelli 40, 47014 Meldola, Italy.
Int J Environ Res Public Health. 2021 Dec 20;18(24):13413. doi: 10.3390/ijerph182413413.
In Italy, drug expenditure governance is achieved by setting caps based on the percentage increase in hospital spending compared to the previous year. This method is ineffective in identifying issues and opportunities as it does not consider an analysis of the number of treated cases and per capita consumption in local and regional settings. The IRCCS (Scientific hospitalization and treatment institute) Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori" in Meldola, has developed and adopted an effective management model designed to oversee pharmaceutical expenditure, guarantee prescription appropriateness and quality of care to patients. The budget setting follows a structured process which evaluates determining factors of the expenditure such as expected patients calculated according to the epidemiology and to national and regional indications of appropriateness, mean cost per patient calculated on the average period of demonstrated efficacy of the drug and use of drugs with the best cost-effectiveness ratio. Strict monitoring and integrated purchasing processes allow for immediate corrective actions on expenditures, as well as a continuous dialogue with the region in order to guarantee consistent funding of IRST activities. The model, presented in this article is efficient and implements concepts beyond the conventional "silos" approach and national and regional governance tools, in terms of patient centricity.
在意大利，通过设定基于与前一年相比医院支出增长百分比的上限来实现药物支出管理。这种方法在识别问题和机会方面效果不佳，因为它没有考虑到对当地和地区环境中治疗病例数量和人均消费的分析。位于 Meldola 的意大利肿瘤研究所（IRCCS）“Dino Amadori”研究所开发并采用了一种有效的管理模式，旨在监督药物支出，保证处方的适当性和对患者的护理质量。预算设定遵循一个结构化的过程，该过程评估支出的决定因素，如根据流行病学和国家及地区的适当性计算预期患者、根据药物已证明的疗效平均周期计算每位患者的平均成本以及使用具有最佳成本效益比的药物。严格的监测和综合采购流程允许对支出进行即时的纠正措施，并与地区保持持续的对话，以保证对研究所活动的持续资助。本文介绍的模型是高效的，并在以患者为中心的理念方面超越了传统的“筒仓”方法和国家及地区治理工具。
