Guidotti Elisa, Seghieri Chiara, Vinci Bruna, Borghini Alice, Attanasio Francesco
Management and Health Laboratory, Institute of Management and Department EMbeDS, Scuola Superiore Sant'Anna, 56127 Pisa, Italy.
SSFO, Pharmacy Department, University of Pisa, 56126 Pisa, Italy.
Pharmaceuticals (Basel). 2022 Oct 8;15(10):1238. doi: 10.3390/ph15101238.
The Italian Medicines Agency (AIFA) and the Italian Regional Health Systems have implemented measures together with data collection and analysis to improve medicines' appropriate prescription. Administrative databases represent rich Real-World Evidence (RWE) sources that may be leveraged for research purposes. Thus, such heritage may allow for appropriate prescription studies to be carried out on complex pharmaceutical molecules, as the appropriateness of prescriptions is essential both for patients' treatment and to ensure healthcare systems' sustainability. This study analyzed the appropriate monoclonal antibodies (mAbs) prescribed in psoriasis treatment across Tuscany, Italy. Data were extracted from several large administrative databases collected by the Tuscan Regional Healthcare System through record linkages. The analysis showed that over 30% of the 2020 cohort of psoriatic patients could be regarded as potentially inappropriate treated, signaling that mAbs are often prescribed as first-line treatment contrary to guidelines. Variation was observed in the appropriate prescription of mAbs, across different types of mAbs and areas. The study revealed potential inappropriate prescription, and its geographic variation should raise awareness among managers about the appropriate use of resources. Despite limitations, this could represent a pilot for future studies to evaluate the appropriate prescription of mAbs in other clinic conditions and across time.
意大利药品管理局（AIFA）和意大利地方卫生系统已采取措施，同时进行数据收集与分析，以改善药品的合理处方。行政数据库是丰富的真实世界证据（RWE）来源，可用于研究目的。因此，这些数据遗产可用于对复杂药物分子进行合理处方研究，因为处方的合理性对于患者治疗和确保医疗系统的可持续性都至关重要。本研究分析了意大利托斯卡纳地区银屑病治疗中开具的合理单克隆抗体（mAb）。数据通过记录链接从托斯卡纳地区医疗系统收集的多个大型行政数据库中提取。分析表明，2020年银屑病患者队列中超过30%可被视为治疗可能不恰当，这表明mAb常被作为一线治疗药物处方，与指南相悖。在不同类型的mAb和地区，mAb的合理处方存在差异。该研究揭示了潜在的不恰当处方，其地理差异应提高管理者对资源合理使用的认识。尽管存在局限性，但这可为未来评估其他临床情况和不同时期mAb合理处方的研究提供一个范例。
