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Ippoliti, R., Falavigna, G., Grosso, F., Maconi, A., Randi, L., Numico, G. (2018). The Economic Impact of Clinical Research in an Italian Public Hospital: The Malignant Pleural Mesothelioma Case Study. International Journal of Health Policy and Management, 7(8), 728-737. doi: 10.15171/ijhpm.2018.13
Roberto Ippoliti; Greta Falavigna; Federica Grosso; Antonio Maconi; Lorenza Randi; Gianmauro Numico. "The Economic Impact of Clinical Research in an Italian Public Hospital: The Malignant Pleural Mesothelioma Case Study". International Journal of Health Policy and Management, 7, 8, 2018, 728-737. doi: 10.15171/ijhpm.2018.13
Ippoliti, R., Falavigna, G., Grosso, F., Maconi, A., Randi, L., Numico, G. (2018). 'The Economic Impact of Clinical Research in an Italian Public Hospital: The Malignant Pleural Mesothelioma Case Study', International Journal of Health Policy and Management, 7(8), pp. 728-737. doi: 10.15171/ijhpm.2018.13
Ippoliti, R., Falavigna, G., Grosso, F., Maconi, A., Randi, L., Numico, G. The Economic Impact of Clinical Research in an Italian Public Hospital: The Malignant Pleural Mesothelioma Case Study. International Journal of Health Policy and Management, 2018; 7(8): 728-737. doi: 10.15171/ijhpm.2018.13

The Economic Impact of Clinical Research in an Italian Public Hospital: The Malignant Pleural Mesothelioma Case Study

Article 7, Volume 7, Issue 8, August 2018, Page 728-737  XML PDF (609 K)
Document Type: Original Article
DOI: 10.15171/ijhpm.2018.13
Authors
Roberto Ippoliti 1, 2; Greta Falavigna3; Federica Grosso4; Antonio Maconi1; Lorenza Randi1; Gianmauro Numico4
1Scientific Promotion, General Hospital of Alessandria, Alessandria, Italy
2Department of Management, University of Turin, Turin, Italy.
3Research Institute on Sustainable Economic Growth, National Research Council of Italy, Moncalieri, Italy
4Oncology Unit, General Hospital of Alessandria, Alessandria, Italy
Abstract
Background
The current economic constraints cause hospital management to use the available public resources as rationally as possible. At the same time, there is the necessity to improve current scientific knowledge. This is even more relevant in the case of patients with malignant pleural mesothelioma (MPM), given the severity of the disease, its dismal prognosis, and the cost of chemotherapy drugs. This work aims to evaluate the standard cost of patients with MPM, supporting physicians in their decision-making process in relation to budget constraints, as well as policymakers with respect research policy.

 
Methods
The authors conducted a retrospective cost analysis on all the patients with MPM who were first admitted to a reference hospital specialized in MPM care between 2014 and 2015, collecting data on their diagnostic pathways and active treatments, as well as on the related official fees for each procedure. Then, using a multiple regression model, we estimated the overall expected cost of a patient with MPM treated in our hospital, to be born by the Regional Healthcare System based on the chosen clinical pathway.

 
Results
According to results, the economic impact of caring for a patient with MPM is mostly related to the selected active treatments, with drug and hospitalization costs as main drivers. Our analysis suggests that the expected reimbursed fee to care for a patient with MPM is equal to € 18 214.99, with chemotherapy and monitoring costs equal to € 12 861.43 and hospitalization cost equal to € 5353.55. This cost decreases to € 320.18 in the case of enrollment in an experimental trial of first-line treatment. In the other cases (second-line or third-line trials), the expected cost borne by the healthcare system for treating patients grows exponentially (€ 40,124.18 and € 59 839.94, respectively).

 
Conclusion
Experimental trials might be a solution to decrease the economic burden for the public healthcare system only in the case of first-line treatments, where the cost of chemotherapy is relevant. Nevertheless, policy-makers have to accept the sharing of this economic burden between society and the pharmaceutical industry to broaden the current scientific knowledge.

Highlights

Supplementary File (Download)

Keywords
Rare Tumors; Clinical Research; Budget Constraint; Health Planning; Malignant Pleural Mesothelioma
Main Subjects
Economic Evaluations
Full Text

 

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