Drug Utilization of Rifaximin-α in Patients with Hepatic Encephalopathy: Evidence from Real Clinical Practice in Italy
Background and Objectives: This analysis described rifaximin utilization in Italian patients with hepatic encephalopathy (HE). Although rifaximin is effective in preventing HE relapses, therapeutic management and prescriptive attitudes might be improved. Materials and Methods: Between Oct-2020 and Sep-2021, approximately 12.7 million citizens, patients hospitalized for HE, were identified through the ICD-9-CM code 572.2. Among those discharged alive, utilization of rifaximin 550 mg vs. rifaximin 200 mg for two months post-admission was compared. Results: Of 634 patients hospitalized for HE, 447 (70.5%) were discharged alive. In the two following months, 276 (61.7%) received rifaximin, of whom 117 (26.2%) received rifaximin 550 mg (two daily tablets) and 159 (35.6%) received rifaximin 200 mg (six daily tablets); among 171 patients without rifaximin, 56 (32.7%) received lactulose/lactitol. One year after rifaximin initiation, patients on rifaximin 550 mg (vs. 200 mg) were more frequently persistent (i.e., did not interrupt therapy) (78.6% vs. 46.9%, p < 0.001), showed a lower switching proportion (21.4% vs. 40.7%, p < 0.050), and had a mean monthly dose closer to the recommendations of 36,000 mg/month (~33,000 mg/month vs. 11,629 mg/month, respectively). Conclusions: This analysis suggests suboptimal rifaximin utilization for HE management. Although rifaximin 550 mg is the only formulation with specific indication and reimbursability to prevent HE relapses in Italy, rifaximin 200 mg is more largely used. The need to improve rifaximin prescribing choices is supported by higher persistence, lower switching rates, and average doses aligned to recommendations in patients treated with rifaximin 550 mg.
The Economic Burden of Herpes Zoster in Individuals Aged 50 Years or Older and Those With Underlying Conditions in Italy
Background: Risk of herpes zoster (HZ) infection increases with age and immunosuppression. We estimated the impact of HZ and post-herpetic neuralgia (PHN) on direct costs and health care resource utilization (HCRU) in patients ≥50 years, including those with comorbidities, as limited information exists in Italy.
Methods: This retrospective analysis used reimbursement data from local health authorities in Italy (January 2009-June 2022). Cases of HZ and PHN identified by International Classification of Diseases, Ninth Revision, Clinical Modification codes and drug prescriptions were characterized and followed up for 1 year before and after the index date. The direct HCRU costs for patients with HZ/PHN were compared with those for patients without HZ/PHN.
Results: Of the total 193 259 patients with HZ/PHN identified (mean age, 61.6 years), 145 923 were ≥50 years old (immunocompromised: 29.9%; ≥1 chronic condition: 76.1%). During follow-up, 18.8% of patients ≥50 years of age with HZ progressed to PHN complications, and 3618 hospital admissions were reported (median length of stay, 9 days). Drug prescriptions and all-cause hospitalizations were the main contributors to total annual direct health care costs, estimated at M€272 for patients with HZ/PHN, whose burden increased with age. Higher health care costs were observed in patients with HZ/PHN vs patients without HZ/PHN. Moreover, average health care costs were up to 4× higher for patients with HZ and PHN compared with those without PHN.
Conclusions: HZ causes a significant economic impact on the health care system, driven mainly by high costs of medications and hospitalizations among older adults and those with comorbidities, particularly when complicated by PHN.
Differential Adherence to Free and Single‑Pill Combination of Rosuvastatin/Ezetimibe: Findings from a Real‑World Analysis in Italy
Abstract Introduction Adherence to cardiovascular drug treatment can significantly benefit from a reduced pill burden, but data on this matter derived from real-life settings are currently scanty. This analysis assessed the possible changes in adherence in patients treated with rosuvastatin and ezetimibe (ROS/EZE) as free multi-pill combination who switched to ROS/EZE as single-pill combination in… Read More »Differential Adherence to Free and Single‑Pill Combination of Rosuvastatin/Ezetimibe: Findings from a Real‑World Analysis in Italy
Un modello di Activity- Based Costing applicato al processo di gestione dei pazienti con emicrania presso l’IRCCS Fondazione Mondino
An Activity-Based Costing model applied to the management process of patients with migraine at IRCCSMondino FoundationBackground and aim: The ageing of the general population, with the increase in chronic diseases, poses theneed for using technological innovation to face the growing healthcare needs. The present analysis applied theActivity-Based Costing tool in migraine patients followed at the… Read More »Un modello di Activity- Based Costing applicato al processo di gestione dei pazienti con emicrania presso l’IRCCS Fondazione Mondino
Differenze di genere e ipercolesterolemia: evidenze real-world dallo studio WECARE (Women Effective CArdiovascular Risk Evaluation)
Gender differences and hypercholesterolemia: real-world evidence from the study WECARE (Women EffectiveCArdiovascular Risk Evaluation)Introduction: The therapeutic control of LDL-cholesterol is essential in cardiovascular prevention, as recommendedby the recent guidelines.Objective: To evaluate gender differences in terms of demographic and clinical characteristics, treatment pattern,treatment adherence and healthcare costs in patients on lipid-lowering therapy, stratified by cardiovascular riskin… Read More »Differenze di genere e ipercolesterolemia: evidenze real-world dallo studio WECARE (Women Effective CArdiovascular Risk Evaluation)
Real world evidence: patients with alopecia areata in Italy
BACKGROUN D: This real-world analysis aimed at characterizing patients hospitalized for alopecia areata (AA ) in Italy, focusing on comorbidities, treatment patterns and the economic burden for disease management.METHODS: Administrative databases of healthcare entities covering 8.9 million residents were retrospectively browsed to include patients of all ages with hospitalization discharge diagnosis for AA from 2010… Read More »Real world evidence: patients with alopecia areata in Italy
Analisi del percorso terapeutico e del consumo di risorse sanitarie in pazienti diabetici in trattamento insulinico: uno studio di real-world evidence su un campione di ASL della regione Sicilia
Italian reports indicate that more than one-third of patients with type 2 diabetes (T2D) require insulin therapy within 8 years of diagnosis, and commonly basal insulin represents the frontline option. An observational analysis was conducted with the aim of investigating patients treated with basal insulin alone in a sample of Local health Units of Sicily… Read More »Analisi del percorso terapeutico e del consumo di risorse sanitarie in pazienti diabetici in trattamento insulinico: uno studio di real-world evidence su un campione di ASL della regione Sicilia
Analisi real-world della epidemiologia e della gestione terapeutica dei pazienti affetti da fibrosi polmonare idiopatica in un contesto di pratica clinica italiana
La fibrosi polmonare idiopatica (IPF) è spesso diagnosticata tardivamente, con conseguente ritardo nell’inizio di terapie in grado di rallentare la progressione di malattia e il declino della funzione polmonare. Lo studio, condotto in un setting di reale pratica clinica italiana, ha valutato l’impatto dell’intervallo diagnostico di IPF sul burden clinico ed economico della patologia, focalizzandosi su epidemiologia, pattern terapeutico,… Read More »Analisi real-world della epidemiologia e della gestione terapeutica dei pazienti affetti da fibrosi polmonare idiopatica in un contesto di pratica clinica italiana
A real-world analysis of outcomes and healthcare costs of patients on perindopril/indapamide/amlodipine single-pill vs. multiple-pill combination in Italy
This analysis compared adherence, cardiovascular (CV) events and all-cause mortality incidence, and healthcare costs among hypertensive patients treated with perindopril (PER)/indapamide (IND)/amlodipine (AML) in single-pill combination (SPC) vs. multiple-pill combination, in a real-world setting in Italy. In this observational retrospective analysis of Italian administrative databases, adult patients treated with PER/IND/AML between 2010 and 2020 were… Read More »A real-world analysis of outcomes and healthcare costs of patients on perindopril/indapamide/amlodipine single-pill vs. multiple-pill combination in Italy
Profile, Healthcare Resource Consumption and Related Costs in ANCA-Associated Vasculitis Patients: a Real-World Analysis in Italy
Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) are rare autoimmune diseases triggeringinflammation of small vessels. This real-world analysis was focused on the most common AAV forms, granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA), to describe patients’ demographic and clinical characteristics,therapeutic management, disease progression, and the related economic burden. A retrospective analysis was conducted on administrative… Read More »Profile, Healthcare Resource Consumption and Related Costs in ANCA-Associated Vasculitis Patients: a Real-World Analysis in Italy