Ferrario Lucrezia, Menzaghi Barbara, Rizzardini Giuliano, Roccia Alessandro, Garagiola Elisabetta, Bellavia Daniele, Schettini Fabrizio, Foglia Emanuela
HD LAB-Healthcare Datascience LAB, LIUC-Università Cattaneo, Castellanza, Italy.
Infectious Diseases Department, ASST Valle Olona Hospital, Busto Arsizio, Italy.
Pharmacoecon Open. 2025 Mar;9(2):313-326. doi: 10.1007/s41669-024-00542-2. Epub 2024 Nov 12.
The aim of this study was to define the economic and organizational impacts related to a broader utilization of bictegravir/emtricitabine/alafenamide (BIC/FTC/TAF) in Italian clinical practice.
A budget impact analysis-representing the evolution of the Italian National Healthcare Service (NHS) healthcare expenditure over 3 years-was developed, considering the overall Italian population treated for human immunodeficiency virus (HIV). Model input variables were treatment history, therapeutic regimen, development of adverse events, achievement of an undetectable viral load and total direct healthcare costs. Besides the BIA, an organizational impact assessment was conducted to determine the impact on the use of healthcare resources, assessing the release of organizational hospital assets, focusing on the management of drug-related adverse events. Data were collected from scientific evidence, Italian national and regional legislations and healthcare professionals' reports. To verify the robustness of the economic and organizational impact assessment, sensitivity analyses were performed.
Results demonstrate economic savings of about 26 million euros in total health spending, assuming a higher penetration rate for BIC/FTC/TAF. This change in the current case mix would lead to a reduction in the specific costs related to adverse event management (0.9 million euros; - 2.09%) and in the medical management of patients (38 million euros; - 7.79%), with a positive impact on the achievement of virological control. From an organizational perspective, a wider use of BIC/FTC/TAF generates a reduction in the utilization of healthcare resources due to a decrease in adverse events and complications. The model estimated a 19.64% reduction in HIV-related inpatient days, which freed up healthcare professional time.
Capable of improving both economic and organizational sustainability for the entire HIV care continuum, BIC/FTC/TAF is an efficient therapeutic strategy for people with HIV.
本研究旨在确定在意大利临床实践中更广泛使用比克替拉韦/恩曲他滨/丙酚替诺福韦（BIC/FTC/TAF）所产生的经济和组织影响。
开展了一项预算影响分析（代表意大利国家医疗服务体系（NHS）三年医疗支出的演变情况），该分析考虑了接受人类免疫缺陷病毒（HIV）治疗的意大利全体人口。模型输入变量包括治疗史、治疗方案、不良事件的发生情况、病毒载量不可检测的实现情况以及直接医疗总成本。除了预算影响分析外，还进行了组织影响评估，以确定对医疗资源使用的影响，评估医院组织资产的释放情况，重点关注药物相关不良事件的管理。数据收集自科学证据、意大利国家和地区法规以及医疗专业人员的报告。为验证经济和组织影响评估的稳健性，进行了敏感性分析。
结果表明，假设BIC/FTC/TAF的渗透率更高，总体医疗支出可节省约2600万欧元。当前病例组合的这种变化将导致与不良事件管理相关的特定成本降低（90万欧元；-2.09%）以及患者医疗管理成本降低（3800万欧元；-7.79%），对病毒学控制的实现产生积极影响。从组织角度来看，更广泛使用BIC/FTC/TAF会因不良事件和并发症的减少而降低医疗资源的利用率。该模型估计与HIV相关的住院天数减少19.64%，从而节省了医疗专业人员的时间。
BIC/FTC/TAF能够提高整个HIV护理连续过程的经济和组织可持续性，是一种针对HIV感染者的有效治疗策略。
