Publications by authors named "Giacomo M Bruno"
Economic Evaluation of Once-Weekly Insulin Icodec from Italian NHS Perspective.
Clinicoecon Outcomes Res
November 2024
Background: Icodec, once-weekly basal insulin, aims to simplify therapy management by reducing injection frequency for diabetic patients. The efficacy and safety of icodec were evaluated in the ONWARDS clinical development program. This study evaluates icodec economic and quality of life impact from the Italian National Healthcare System (NHS) perspective.
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- Metabolic dysfunction-associated steatotic liver disease (MASLD) is a rising health issue in Italy, with the study evaluating its economic burden on the National Healthcare Service.
- Utilizing an Excel model, researchers compared healthcare costs and complications associated with MASLD against a similar population without it, revealing significant financial and mortality impacts.
- The study estimates that MASLD could cost the Italian healthcare system over €12 billion annually and result in approximately 13,438 extra deaths, highlighting the need for lifestyle changes and future pharmaceutical interventions.
Introduction: The underdiagnosis of chronic kidney disease (CKD) remains a significant public health concern. The Early chroNic kiDney disease pOint of caRe Screening (ENDORSE) project aimed to evaluate the clinical and economic implications of a targeted training intervention for general practitioners (GPs) to enhance CKD awareness and early diagnosis.
Methods: Data on estimated Glomerular Filtration Rate (eGFR) and Urinary Albumin-Creatinine Ratio (uACR) were collected by 53 Italian GPs from 112,178 patients at baseline and after six months.
Article Synopsis
- Paroxysmal nocturnal hemoglobinuria (PNH) is a rare disease leading to hemolysis, with C5 inhibitors improving treatment but having limited effects on some hemolysis types.
- The newly approved C3 inhibitor, pegcetacoplan, effectively reduces both intravascular and extravascular hemolysis, enhancing hemoglobin levels and quality of life for patients.
- A cost-utility analysis showed pegcetacoplan is less expensive over 5 years (€1,483,454) compared to C5 inhibitors and provides greater increases in quality-adjusted life years (QALYs) while reducing management costs associated with complications.
Article Synopsis
- The study looks at how different types of medications, called biological drugs and biosimilars, affect health care costs for patients with certain diseases, especially in rheumatology.
- Researchers examined 145 patients and found that most were using the original biological drugs instead of the biosimilars, even though patients using biosimilars showed better adherence to treatment.
- The total health costs for these patients over one year was quite high, with a large portion going toward medications, and the study suggests that better communication among health professionals could help more people use biosimilars.
Economic Evaluation for Palbociclib Plus Fulvestrant vs Ribociclib Plus Fulvestrant and Abemaciclib Plus Fulvestrant in Endocrine-Resistant Advanced or Metastatic Breast Cancer in Italy.
Ther Clin Risk Manag
March 2023
Background: To date, no study evaluated the cost-effectiveness of palbociclib (PAL) plus fulvestrant (FUL) vs ribociclib (RIB) plus FUL and abemaciclib (ABM) plus FUL in Italy. Cost-effectiveness analysis comparing the three cyclin-dependent 4/6 kinase inhibitors in combination with endocrine therapies for the management of postmenopausal women with HR+, HER2- advanced or metastatic breast cancer in Italy was developed.
Material And Methods: To assess the cost-effectiveness of PAL plus FUL vs RIB plus FUL and ABM plus FUL, a cost-minimization has been carried out with a conservative scenario considering three CDK4/6 inhibitors with equal effectiveness in terms of overall survival (OS) (MAIC, Rugo et al 2021).
Background: Aim of our study is to evaluate the economic impact of NASH among diabetic population in Italy and potential benefits of treatments that can slow the disease progression.
Methods: A Markov model was conducted from the Italian National Healthcare System perspective reporting results at 3, 5, 10 and 15 years. The model included NASH and T2DM patients with all stages of fibrosis (F0-F3), compensated cirrhosis (CC), decompensated cirrhosis (DCC), hepatocellular carcinoma (HCC), liver transplant (LT), post-LT and death.
Aim: To evaluate if VSL#3 [a high-concentration multi-strain probiotic mix containing one strain of BT01, three strains of ( BB02; subspecies [subsp.] BL03, previously identified as BL03; and subsp. BI04, previously identified as BI04), and four strains of ( BA05, BP06, BP07, and BD08, previously identified as subsp.
View Article and Find Full Text PDFWastage of gonadotropins during IVF cycles: Real life data from two Italian infertility centers.
Eur J Obstet Gynecol Reprod Biol
December 2021
Background: Gonadotropins represent an important component of IVF costs. In order to reduce costs, much attention was given to the type of gonadotropins (recombinant versus urinary) and the daily dose. In this study, we decided to focus on gonadotropin wastage, a neglected aspect that may harbor a relevant source of useless economic expenditure.
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- The COVID-19 lockdown in Italy led to a significant reduction in outpatient visits, especially among diabetic patients, raising concerns about their health outcomes.
- Diabetic individuals experienced a 28% drop in access to healthcare and a mortality rate of 20.4%, double that of the general population, highlighting the pandemic's severe impact on this group.
- The study estimated a financial burden on the National Health Service of €26.6 million and a significant loss in quality of life, indicating the negative consequences of delayed treatment and reduced access to innovative therapies.
A one health framework to estimate the cost of antimicrobial resistance.
Antimicrob Resist Infect Control
November 2020
Objectives/purpose: The costs attributable to antimicrobial resistance (AMR) remain theoretical and largely unspecified. Current figures fail to capture the full health and economic burden caused by AMR across human, animal, and environmental health; historically many studies have considered only direct costs associated with human infection from a hospital perspective, primarily from high-income countries. The Global Antimicrobial Resistance Platform for ONE-Burden Estimates (GAP-ON€) network has developed a framework to help guide AMR costing exercises in any part of the world as a first step towards more comprehensive analyses for comparing AMR interventions at the local level as well as more harmonized analyses for quantifying the full economic burden attributable to AMR at the global level.
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- The study examined the impact of Vitamin D3 on glyco-metabolic control in type 2 diabetic patients who are Vitamin D deficient, with 117 patients in the placebo group and 122 in the Vitamin D3 group.
- After 6 months, the Vitamin D3 group showed significant improvements in fasting and post-prandial glucose levels, as well as a reduction in HbA1c levels compared to both their baseline and the placebo group.
- Patients receiving Vitamin D3 also required lower doses of oral hypoglycemic agents and insulin, suggesting improved diabetes management from Vitamin D3 supplementation.
Diabetes treatment cost represents an ever-growing problem. The adoption of new drugs in therapy, although they can guarantee an improvement in patient's quality of life, can meet obstacles when it involves an increase in costs. We decided to compare the costs and benefits of the new saxagliptin and dapagliflozin combination versus traditional therapies.
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- Diabetes is a global public health issue, leading to serious complications and increased treatment costs, prompting a study on the economic impact of dulaglutide as a diabetes treatment alternative.
- The study utilized a cost-utility analysis to compare the total costs of dulaglutide versus gliclazide (a sulfonylurea) and basal insulin, with a focus on their effectiveness alongside metformin in type II diabetic patients.
- Results indicated that while dulaglutide is more expensive upfront than gliclazide and basal insulin, it may lead to lower overall costs in terms of self-monitoring and hypoglycemia-related expenses.
Introduction: Inadequately controlled severe asthma patients require additional therapy accounting for significant clinical and economic burden. Our analysis aims to determine the cost-effectiveness of omalizumab in the management of severe allergic asthma in Italy based on observational data from the PROXIMA study.
Methods: Observational data on efficacy, healthcare resource utilization and changes in quality of life at 12 months after the initiation of omalizumab were examined to estimate the cost-effectiveness compared to pre-omalizumab period and results were expressed with Incremental Cost-Effectiveness Ratio (ICER).
Article Synopsis
- Asthma is a chronic inflammatory disease affecting quality of life, and the Asthma Quality of Life Questionnaire (AQLQ) is a key tool for measuring patient-reported outcomes (PROs).
- A systematic review was conducted following PRISMA guidelines to assess long-term QoL outcomes related to omalizumab therapy in patients with moderate-to-severe allergic asthma, reviewing studies published until February 2018.
- Results from eight selected studies highlighted that omalizumab significantly improves both subjective and objective measures of asthma control over time, although the observational nature of these studies may introduce selection bias concerns.
Shadow cost of oral corticosteroids-related adverse events: A pharmacoeconomic evaluation applied to real-life data from the Severe Asthma Network in Italy (SANI) registry.
World Allergy Organ J
January 2019
Background: Asthma is one of the most common non-communicable respiratory diseases, affecting about 6% of the general population. Severe asthma, even if afflicts a minority of asthmatics, drives the majority of costs of the disease. The aim of this study is to create a pharmacoeconomic model to predict the costs of corticosteroid-related adverse events in severe asthmatics and applying it to the first published epidemiologic data from the Severe Asthma Network in Italy (SANI) registry.
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- Secukinumab is a monoclonal antibody approved in Europe for treating moderate-to-severe psoriasis, psoriatic arthritis, and ankylosing spondylitis since 2015, with a budget impact assessment conducted for its introduction into the Italian market.
- A budget impact model projected the number of patients treated with secukinumab to increase from 6,648 in the first year to 12,001 by the third year, estimating a total savings of €66.1 million over three years, largely due to savings in ankylosing spondylitis treatment.
- The analysis confirmed that introducing secukinumab would lead to a -5% cumulative budget impact over three years, indicating cost-effectiveness compared to scenarios
Background: Diabetes represents a relevant public health problem worldwide due to its increasing prevalence and socioeconomic burden. There is no doubt that tight glycemic control reduces the development of diabetic complications such as the long-term costs related to the disease. The aim of our model was to calculate total direct costs associated with the two treatments considered in DUAL VII study, and hence evaluate the potential economic benefits for the National Health System (NHS) deriving from the use of insulin degludec plus liraglutide (IDegLira) in a once-daily fixed combination.
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- Anas barbariae hepatis et cordis extractum 200K (Oscillococcinum) is investigated for its effectiveness in preventing respiratory tract infections (RTIs) and its cost implications for the Italian National Health Service (NHS).
- Data from a study involving 455 patients showed that those treated with the extract had fewer RTI episodes and incurred lower healthcare costs compared to those who were not treated.
- The findings indicate that this treatment not only helps in reducing the frequency of RTIs but also results in significant savings for the NHS.
Article Synopsis
- The study focuses on the economic impact of Clostridium difficile infection (CDI) in Italy, particularly in the Florence health care system, highlighting the lack of research on the economic costs associated with CDI.
- It involved a retrospective analysis of 69 patients hospitalized with CDI in 2013, revealing an average hospitalization duration of 12.8 days and a significant average cost of €3,270.52 per patient.
- The findings indicate that prolonged hospital stays contribute the most to these costs, emphasizing the need for better diagnostic and treatment strategies to manage CDI effectively.
Objectives: Costs may play a role in deciding how and when to start highly active antiretroviral therapy (HAART) in a naïve patient. The aim of the present study was to assess the cost- effectiveness of treatment with HAART in a large clinical cohort of naïve adults to determine the potential role of single-tablet regimens in the management of patients with human immunodeficiency virus (HIV). An incremental cost-effectiveness ratio analysis was performed, including a quality-adjusted life year approach.
View Article and Find Full Text PDFEconomic and outcomes consequences of TachoSil®: a systematic review.
Vasc Health Risk Manag
April 2015
Background: TachoSil(®) is a medicated sponge coated with human fibrinogen and human thrombin. It is indicated as a support treatment in adult surgery to improve hemostasis, promote tissue sealing, and support sutures when standard surgical techniques are insufficient. This review systematically analyses the international scientific literature relating to the use of TachoSil in hemostasis and as a surgical sealant, from the point of view of its economic impact.
View Article and Find Full Text PDFObjective: The utilization of diagnostic imaging has substantially increased over the past decade in Europe and North America and continues to grow worldwide. The purpose of this study was to develop an economic evaluation of a syringeless power injector (PI) versus a dual-syringe PI for contrast enhanced computed tomography (CECT) in a hospital setting.
Materials And Methods: Patients (n=2379) were enrolled at the Legnano Hospital between November 2012 and January 2013.