Analisi comparativa del mercato dei dispositivi per incontinenza in cinque paesi europei

The aim of the paper is to compare and valutate the market of the incontinence devices in five European countries: Italy, France, Germany, U.K. and Denmark. We chose incontinence devices because they are strictly connected with the development of the home delivery. France, Germany and U.K. has been analysed for their politic and territorial importance, while Denmark has been considered for its home assistance system. A common pattern has been applied in every country: first of all there is a general outline of the legislative aspect of the incontinence devices, then the study presents prescription procedure and the different models of distribution. Finally, it shows the competitive systems of the pharmaceuticals industry in every single country. The necessary information has been gathered through relevant literature and interviews with the area operators. The incontinence devices are repayable in all the studied countries, except from France. Every country has different health system (Italy, U.K and Denmark had a public health system; France and Germany has a mutualist health system). There isn’t an evident correlation between the type of the health system and the market of the incontinence devices

Efficienza tecnologica e produttiva delle strutture trasfusionali in Italia

In all the developed countries the methods of blood collection and production are relevant subjects for the pharmacoeconomics studies, because of their health and economic implications related to the health policies in this area. The “blood market” rappresents an area where the sanitary items, the economic items and also the ethic items must be broached at the same time; therefore it can be considered emblematic. By this situation arises Progetto CO.R.SA. (COsti Raccolta SAngue), a project for estimating productivity and cost for a representive sample of italian trasfusional structure (ST). The study is supported by Società Italiana di Medicina Trasfusionale e Immunoematologia (SIMTI). In Italy there are about 380 ST, but only 30 ST resulted suitable for the study. The analysis investigates six rates concerning: a) wastes; b) technological efficiency; c) personnel productivity. The present work describes only the informations on ST organization and production, delaying the results about costs to a specific further report

Il mercato dei dispositivi per stomia in cinque paesi europei: lezioni per l’Italia

Aim of the present study is to analyze the international market of the ostomy devices in Italy, France, Germany, U.K. and Denmark. The ostomy systems are technologically mature devices, and the more interesting market developments are about innovative modality of distribution and patients technical support, like home distribution. For every country it has been applied a common pattern, based on four aspect of the ostomy devices market: 1. the legislative aspect; 2. the prescription procedure; 3. the different models of distribution; 4. the competitive systems of pharmaceutical industry. All the data in this study has been galthered through relevant literature and interviews with the area operators. The ostomy devices are repayable against medical prescription in all the studied countries; significant legislative differences are registered in the repayment prices determination. For all the studied countries, in the decisional process related to the choice of one or another device, the essential role is played by the ostomy hospital nurse, that advises the patient immediately after the surgery. Finally, the more significant examples to innovate purchase and distribution process of ostomy devices in Italy comes from Denmark and U.K., where the home distribution is already available and it is working

Il costo medio per tipologia di prestazione nei centri trasfusionali

In Italy the collection, validation and separation of blood and its derivatives for transfusional interventions are carried out by some 380 transfusional centers (TCs), mainly located within greater health care structures. The aim of the CORSA (Costi Raccolta Sangue) study was to furnish an estimate of the mean cost of the main transfusional services on a sample of the Italian TCs. Of the centers contacted, only 13,3% were able to deliver the unit costs necessary to perform the full-cost, fully-allocated analysis conducted. Of the three services examined (apheresis of plasma and platelets, whole blood collection), the selective collection of thrombocytes resulted the most expensive, as opposed to whole blood collection. The mean cost of a erythrocyte, plasma and platelet unit resulted of 17,7, 21,6 and 89,8 •, respectively, although the variation among centers was substantial. To main conclusions can be drawn by the CORSA study. First, the very low percentage of TCs able to provide the necessary data for a complete economical analysis highlights an important delay in the modernizing process of health care management, started in 1992 with the aim to ameliorate resource allocation. Second, the study was not able to establish a relationship between production volume and production cost, indicating the absence of scale economy features in transfusional processes

Prices and distribution margins of in-patent drugs in pharmacy: A comparison in seven European countries

Objectives To compare prices of in-patent active ingredients (AIs) in Europe at three levels (ex-factory prices, net distribution margins and third party payers' prices).Methods We compared the prices in seven EU countries (Belgium, France, Germany, Italy, the Netherlands, Spain and the UK) of the 20 in-patent AIs most sold on the Italian retail market in 2004, based on "sell in" sales data. We calculated the average ex-factory price per unit of each compound in each of the seven countries, weighted by the volumes of all reimbursable package sizes and strengths. We estimated net distribution margins according to the 2004 domestic regulations by deducting any type of mandatory discount. Finally, we added VAT to calculate "third party payer's prices". All prices were expressed in index numbers (Italy = 100).Results Italy had the lowest average ex-factory prices, the Netherlands and particularly the UK had by far the lowest distribution margins, while Germany had by far the highest third party payers' prices. The Netherlands and particularly UK showed a steep decrease from ex-factory to third party payers' prices, while Belgium, Italy and Spain gave the opposite pattern.Conclusions Our study suggests that public authorities can deal with drug prices both by strictly controlling ex-factory prices and by establishing appropriate distribution margins. The latter might be facilitated by liberalizing the distribution sector.