A table of 69 active ingredients is ready which will allow the Local Health Authorities to reduce the current, often significant, cost differences
12 September 2014 – La Repubblica Salute
ROME - After years of chaos, the Public Contracts Observatory is trying to bring order to the jungle of medicine prices. The institute has in fact developed the first reference prices, based on a more detailed comparison by type and quality than the one published in 2012, which brought to light huge differences in spending. For example, it was discovered that there were Local Health Authorities that paid 284 euros for hip prosthesis inserts and other healthcare companies that disbursed over 2,500 euros.
Several companies, such as the biomedical ones, criticized the criterion adopted by the Authority and turned to the administrative courts, which effectively found deficiencies in the classification system of medical devices. Now, also following the observations made by some Tars, the work has been improved and redefined. At present, the survey concerns 116 reference prices obtained from the disaggregation of 69 active ingredients for hospital use, including antibiotics, chemotherapy, anti-hepatitis, antifungals, divided in turn according to dosage and form (vial, bottle, capsule, syringe). But the Observatory will soon be able to set the 'right prices' also for medical devices and for cleaning, laundry and catering services.
Adnkoronos Salute reports that fromtable analysis it emerges, for example, that the reference price of paracetamol in vials (10 MG/ML 50 ML) is 0.75 euros. The price of the heparin sodium anticoagulant in vials (25,000 IU 5 ML) is instead 2.05 euros. For human antithrombin III (dosage 1000 IU in bottle) it is 145 euros, an amount that corresponds to the minimum price recorded by the Observatory in 2012. Even if there were Local Health Authorities who, it turned out, paid 330 euros for the same drug.
Taking other examples, the reference price of pegylated erythropoietin in vial/syringe (MCG dosage) is equal to 1.16 euros, while that of rituximab (500 MG/50 ML) in vials – monoclonal antibody used for the treatment of lymphoma non-Hodgkin – is set at 1,318.19 euros. The 40 mg/ml bottle of ribavirin – a drug indicated for the treatment of hepatitis C – is set at 56.86 euros.
“The reference price provided – explains the Observatory – represents, for most of the medicines published, the tenth percentile, given the high homogeneity of these products and the statistical significance found. For other drugs, the choice of percentile fell, as envisaged by the law, on the 20th or 25th percentile based on considerations of statistical significance and the heterogeneity of the observed data”.
We have arrived at this first table after a long work. The procedure for the publication of the reference prices was in fact divided into several phases: the acquisition from the National Agency for Regional Health Services (Agenas) of the lists of goods and services for which to publish the reference price; the preparation of questionnaires for data collection; online consultation with the main operators in the sector; the design, development and testing of the telematic procedure for data collection; the collection of information data and assistance to the contracting authorities; checking the consistency/quality of the data received; the economic-statistical analysis of the data received and the elaboration of the reference prices.
"The 2014 survey - specifies the Observatory - was aimed at all administrations operating in the health sector (more than 280) while that of 2012 was aimed at 66 administrations selected from among the most representative ones at regional level".
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