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Direct Healthcare Costs by Level of Adherence of a Real-World Population of Statin Users in Italy

PURPOSE: This real-world study investigates the direct healthcare costs from the perspective of the Italian Healthcare National Service of experienced statin users according to their level of adherence to therapy and to their cardiovascular (CV) profile in Italian settings of outpatients clinical pr...

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Autores principales: Degli Esposti, Luca, Veronesi, Chiara, Ancona, Domenica Daniela, Andretta, Margherita, Bartolini, Fausto, Drei, Alberto, Lupi, Alessandro, Palcic, Stefano, Re, Davide, Rizzi, Francesca Vittoria, Giacomini, Elisa, Perrone, Valentina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8922236/
https://www.ncbi.nlm.nih.gov/pubmed/35299992
http://dx.doi.org/10.2147/CEOR.S345852
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author Degli Esposti, Luca
Veronesi, Chiara
Ancona, Domenica Daniela
Andretta, Margherita
Bartolini, Fausto
Drei, Alberto
Lupi, Alessandro
Palcic, Stefano
Re, Davide
Rizzi, Francesca Vittoria
Giacomini, Elisa
Perrone, Valentina
author_facet Degli Esposti, Luca
Veronesi, Chiara
Ancona, Domenica Daniela
Andretta, Margherita
Bartolini, Fausto
Drei, Alberto
Lupi, Alessandro
Palcic, Stefano
Re, Davide
Rizzi, Francesca Vittoria
Giacomini, Elisa
Perrone, Valentina
author_sort Degli Esposti, Luca
collection PubMed
description PURPOSE: This real-world study investigates the direct healthcare costs from the perspective of the Italian Healthcare National Service of experienced statin users according to their level of adherence to therapy and to their cardiovascular (CV) profile in Italian settings of outpatients clinical practice. PATIENTS AND METHODS: A retrospective observational analysis was performed based on administrative databases covering approximately 6 million health-assisted individuals. Adult patients with statins prescription between January 2014 and December 2016 were screened, and first prescription within this period was the index date. Follow-up lasted 1 year after index date. Only patients receiving statins prior index date (experienced statin users) were included and distributed in clusters based on their CV profile. Adherence was calculated during follow-up as proportion of days covered (PDC) and classified in low adherence (PDC<40%), partial adherence (PDC=40–79%) and adherence (PDC≥80%). Mean direct healthcare costs of drugs, hospitalizations, and outpatient services were evaluated during follow-up. RESULTS: A total of 436,623 experienced statin users were included and distributed as follows: 5.5% in the previous CV events, 22.6% in diabetes, 55.7% in CV treatments and 16.2% in the no comorbidity cluster. Total mean annual cost/patient decreased from low adherent to adherent patients from €4826 to €3497 in previous CV events, from €2815 to €2360 in diabetes cluster, from €2077 to €1863 for patients with CV treatments. Same trend was reported for the cost item related to hospitalizations, which was the major determinant of the total costs. In previous CV event cluster, adherence was associated to a saving of €879 on total costs. CONCLUSION: The study highlighted a decrease in overall mean costs as adherence levels increase, particularly for patients with previous CV events, showing how improving adherence could be associated to cost savings and suggesting suited strategy based on CV profile should be undertaken for adherence optimization.
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spelling pubmed-89222362022-03-16 Direct Healthcare Costs by Level of Adherence of a Real-World Population of Statin Users in Italy Degli Esposti, Luca Veronesi, Chiara Ancona, Domenica Daniela Andretta, Margherita Bartolini, Fausto Drei, Alberto Lupi, Alessandro Palcic, Stefano Re, Davide Rizzi, Francesca Vittoria Giacomini, Elisa Perrone, Valentina Clinicoecon Outcomes Res Original Research PURPOSE: This real-world study investigates the direct healthcare costs from the perspective of the Italian Healthcare National Service of experienced statin users according to their level of adherence to therapy and to their cardiovascular (CV) profile in Italian settings of outpatients clinical practice. PATIENTS AND METHODS: A retrospective observational analysis was performed based on administrative databases covering approximately 6 million health-assisted individuals. Adult patients with statins prescription between January 2014 and December 2016 were screened, and first prescription within this period was the index date. Follow-up lasted 1 year after index date. Only patients receiving statins prior index date (experienced statin users) were included and distributed in clusters based on their CV profile. Adherence was calculated during follow-up as proportion of days covered (PDC) and classified in low adherence (PDC<40%), partial adherence (PDC=40–79%) and adherence (PDC≥80%). Mean direct healthcare costs of drugs, hospitalizations, and outpatient services were evaluated during follow-up. RESULTS: A total of 436,623 experienced statin users were included and distributed as follows: 5.5% in the previous CV events, 22.6% in diabetes, 55.7% in CV treatments and 16.2% in the no comorbidity cluster. Total mean annual cost/patient decreased from low adherent to adherent patients from €4826 to €3497 in previous CV events, from €2815 to €2360 in diabetes cluster, from €2077 to €1863 for patients with CV treatments. Same trend was reported for the cost item related to hospitalizations, which was the major determinant of the total costs. In previous CV event cluster, adherence was associated to a saving of €879 on total costs. CONCLUSION: The study highlighted a decrease in overall mean costs as adherence levels increase, particularly for patients with previous CV events, showing how improving adherence could be associated to cost savings and suggesting suited strategy based on CV profile should be undertaken for adherence optimization. Dove 2022-03-10 /pmc/articles/PMC8922236/ /pubmed/35299992 http://dx.doi.org/10.2147/CEOR.S345852 Text en © 2022 Degli Esposti et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Degli Esposti, Luca
Veronesi, Chiara
Ancona, Domenica Daniela
Andretta, Margherita
Bartolini, Fausto
Drei, Alberto
Lupi, Alessandro
Palcic, Stefano
Re, Davide
Rizzi, Francesca Vittoria
Giacomini, Elisa
Perrone, Valentina
Direct Healthcare Costs by Level of Adherence of a Real-World Population of Statin Users in Italy
title Direct Healthcare Costs by Level of Adherence of a Real-World Population of Statin Users in Italy
title_full Direct Healthcare Costs by Level of Adherence of a Real-World Population of Statin Users in Italy
title_fullStr Direct Healthcare Costs by Level of Adherence of a Real-World Population of Statin Users in Italy
title_full_unstemmed Direct Healthcare Costs by Level of Adherence of a Real-World Population of Statin Users in Italy
title_short Direct Healthcare Costs by Level of Adherence of a Real-World Population of Statin Users in Italy
title_sort direct healthcare costs by level of adherence of a real-world population of statin users in italy
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8922236/
https://www.ncbi.nlm.nih.gov/pubmed/35299992
http://dx.doi.org/10.2147/CEOR.S345852
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