New Highly Active Antiretroviral drugs and generic drugs for the treatment of HIV infection: a budget impact analysis on the Italian National Health Service (Lombardy Region, Northern Italy)

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Abstract

Background

In the healthcare sector, it is crucial to identify sustainable strategies in order to allow the introduction and use of innovative technologies. Now, and over the next few years, the expiry of patents for different antiretroviral drugs offers an opportunity to increase the efficiency of resources allocation. The aim of the present study was to assess the impact, on the budget of the Italian National Healthcare Service, of generic antiretroviral drugs and of new antiretroviral drugs entering the market from 2015 to 2019.

Methods

A budget impact model was developed in order to forecast the rate of use of ARTs, based on trends observed within the Lombardy Region (Italy), on clinical experts’ opinion, and the consequent impact on the Italian NHS budget in a five year time horizon. Different scenarios were developed, considering the sole introduction of generic drugs, of new drugs, and their cumulative effects. A multivariate sensitivity analysis was also performed.

Results

The cumulative use of generic drugs and new drugs would lead to annual savings of 4.6 million € (-0.6 %) in 2015; 16.9 million € (-2.1 %) in 2016; 19.4 million € (-2.4 %) in 2017; 51.1 million € (-6.1 %) in 2018 and -110.3 million € (-12.8 %) in 2019. The impact of new drugs in percentage terms is +2.0 % in 2015, +3.4 % in 2016, +3.9 % in 2017, +5.7 % in 2018 and +7.7 % in 2019. The impact of generic drugs would lead to savings of 4.9 million € in 2015, 18.6 million € in 2016, 22.8 million € in 2017, 76.5 million € in 2018 and 187.4 million € in 2019.

The sensitivity analysis showed annual mean savings for the Italian NHS ranging from 12.6 million €, -1.5 % compared to the base case scenario (decreasing all the rates of transition used in the simulation, and increasing the cost of generic drugs) to 76.0 million €, -9.1 % (increasing all the rates of transition used in the simulation, and decreasing the cost of generic and new drugs).

Conclusions

The use of antiretroviral generic drugs may lead to savings that would compensate the expenditure increase due to new, innovative drugs available on the market.

Electronic supplementary material

The online version of this article (doi:10.1186/s12879-015-1077-7) contains supplementary material, which is available to authorized users.

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Author and article information

Contributors

Umberto Restelli: urestelli@gmail.com

Francesca Scolari: francesca.scolari2@gmail.com

Paolo Bonfanti: pa.bonfanti@ospedale.lecco.it

Davide Croce: d.croce@tiscali.it

Giuliano Rizzardini: rizzardini.giuliano@hsacco.it

Journal

Journal ID (nlm-ta): BMC Infect Dis

Journal ID (iso-abbrev): BMC Infect. Dis

Title: BMC Infectious Diseases

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2334

Publication date (Electronic): 11 August 2015

Publication date PMC-release: 11 August 2015

Publication date Collection: 2015

Volume: 15

Electronic Location Identifier: 323

Affiliations

[ ]Centre for Research on Organisation, Innovation and Leadership in Healthcare (CROILS), IRCCS Ospedale San Raffaele, Milan, Italy

[ ]School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

[ ]Department of Infectious and Tropical Diseases, A. Manzoni Hospital, Lecco, Italy

[ ]First and Second Divisions of Infectious Diseases, “Luigi Sacco” Hospital, Milan, Italy

[ ]School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

Article

Publisher ID: 1077

DOI: 10.1186/s12879-015-1077-7

PMC ID: 4531431

PubMed ID: 26259842

SO-VID: 2a905f6c-d8f4-4e59-b87e-7dbcb6ed5d1d

License:

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 3 February 2015

Date accepted : 31 July 2015

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ScienceOpen disciplines: Infectious disease & Microbiology

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ScienceOpen disciplines: Infectious disease & Microbiology

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New Highly Active Antiretroviral drugs and generic drugs for the treatment of HIV infection: a budget impact analysis on the Italian National Health Service (Lombardy Region, Northern Italy)

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Abstract

Background

Methods

Results

Conclusions

Electronic supplementary material

Related collections

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Most cited references 11

Delivering affordable cancer care in high-income countries.

HIV drug development: the next 25 years.

High and rising health care costs. Part 2: technologic innovation.

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Contributors

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Article

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Cited by 5

Most referenced authors 676