Is it better the egg today or the chicken tomorrow? At times, at least in health care, it may be more appropriate to look less at current spending in order to think more closely about how much we will consume in the future, precisely because we have not obtained the best therapeutic result. For cardiovascular diseases alone, achieving adequate cholesterol control could mean saving around three billion three hundred million euros a year in the years to come, at least on the basis of the projections emerging from a study carried out by Vincenzo Atella, professor of economics at the Faculty of Economics of the "Tor Vergata" University of Rome. On these bases, a major training initiative for general practitioners was born, which will involve all of Italy and will have as its objective the achievement of therapeutic appropriateness, i.e. the need to better personalize therapy for each individual patient. «The family doctors project – explained Giacomo Milillo, Secretary General of the Italian Federation of General Practitioners (Fimmg) in Rome recently – is not one of the many ideas on a blank sheet, but is already taking shape with four national courses Rome between family doctors and managers of the pharmaceutical sector of the ASL for a shared path. This time the family doctors and NHS managers will be joined by specialists, one hundred courses in 88 local health authorities in all regions. philosophy is the concrete therapeutic appropriateness. in a slogan: the right drug for the right patient at the right time, without conditioning, obviously taking into account the economic context». According to Milillo himself, the role of the family doctor is too often limited to the moment of the prescription. This is because the cost-benefit of the drug is not made on the basis of a global vision and effectiveness in the field but on expenditure, based on a pre-established ceiling. «And instead saving a hundred euros today could mean spending many more tomorrow – is the comment of the Fimmg doctors -. the family doctors and the ASL are highlighting it, in a shared path, in the national courses currently in progress and tomorrow in the local ones ». however, the therapeutic appropriateness in prescribing, at least on the basis of the figures, could prove costly and in contrast with the policy of cost containment. However, perhaps using the most appropriate medicine today could eventually lead to a reduction in a much heavier expense in terms of hospitalization, disability, job loss and even death, as well as of course the great tragedy for the patient and his family. in short: to each his own, remembering that sometimes today's egg can be much less significant than tomorrow's hen. However, let it be clear – Fimmg reiterates – that the most innovative drug should be reserved for the patient who actually needs it, i.e. who must achieve a certain goal to minimize the risk of serious complications. For patients who do not need targeted therapies, the use of generic drugs is perfectly fine, at a lower cost, able to contain the costs in the best possible way for each Healthcare Company. Without forgetting that, whatever the therapy, the patient must follow the doctor's instructions over time: otherwise, if he does not "adhere" to the treatments, the results will still be difficult to obtain. page edited by feDeriCo mereta THE CHOLESTEROL CASE In the survey on a sample of 15,000 patients coordinated by Vincenzo Atella, professor of economics at the Faculty of Economics of the "Tor Vergata" University of Rome, the diseases c
