Technological innovations in the health sector have economic implications that go beyond their effects on health expenditure, expanding into other areas of the state budget (e.g., the social security system). Furthermore, innovation can affect the production of wealth by workers and companies, which in turn affects tax revenues. In addition, the presence of chronic diseases tends to reduce the propensity to consume and changes the allocation of consumption between the different sectors. Allocative decisions in the health system are rarely supported by an analysis that combines the health effects of innovations and their consequences in the economic system.

The objective of this study was to estimate the value of management programs for patients suffering from type 2 diabetes mellitus that involved different levels of use of innovative technologies and drugs. A tax impact assessment methodology was adopted in the context of chronic conditions to analyze the effect of adopting alternative management models for patients with diabetes on the broader economic system.

Assuming a policy that reduces annual complications by 0.42 percent, there was an increase in tax revenue (cumulative value) of approximately EUR 28,175 and a reduction in productivity losses (cumulative value) of EUR 4,049,890. Projecting the impact on the age trend of the population up to 65 years of age with these estimates, it is possible to have an increase in tax revenue (cumulative value) equal to approximately EUR 7,050,598 and a reduction in productivity losses (cumulative value) equal to EUR 140,235,923.

In light of this work, providing remote patient support (telemedicine) and expanding the provision of innovative oral antidiabetic drugs to family physicians could improve care for patients with type 2 diabetes mellitus. This study provides decision makers with an immediately usable model to broaden the information base for planning and regulatory choices. In addition, it supports the use of economic evaluations that calculate the entire value of a technological innovation or health program.

Diabetic Macular Edema (DME) is an important complication of Diabetic Retinopathy (DR). Intravitreal steroids in slow-release systems represent a safe and effective therapeutic option for the management of DME, capable of improving patients’ quality of life by reducing the number of injections thus increasing the therapeutic adherence and the effectiveness of the treatment. This study aims to determine the economic impact of DME and the consequences, in terms of both expenditure and organizational impact, associated with a greater use of the intravitreal dexamethasone implant.

The analysis entailed the comparison between two scenarios: a first scenario based on the current use of therapeutic alternatives available in the Italian healthcare setting (as is) and an alternative scenario based on the assumption of an increased use of intravitreal dexamethasone implant (to be). The results of the analysis are expressed in terms of resource absorption associated with the two scenarios as well as in terms of the cost differential given by their comparison.

Despite an increase in expenditure in terms of acquisition costs of pharmacological alternatives (EUR 898,362) and interventions provided (EUR 22,093,160), the greater use of prolonged-release dexamethasone allows for significant savings in terms of healthcare professionals’ time, follow-up and productivity losses incurred by patient/caregiver. These reductions in healthcare costs resulted in a saving of EUR 1,987,678 over a 5-year period. Such a reduction would allow, considering a total annual management cost of EUR 6,115 for the intravitreal dexamethasone, to treat 325 more patients at the same cost of the as is scenario based on the current rate of use of dexamethasone.

In a context characterized by the need to increase the allocative efficiency of economic resources, the recourse to therapeutic alternatives, such as prolonged release dexamethasone, allowing the reduction of costs for the management of a given pathology is crucial to generate more value for patients and the entire society.

Cystic Fibrosis (CF) is a genetic disorder caused by mutations in CFTR gene. In Italy, reported prevalence is approximately .70 per 10,000 inhabitants (1). The practice and recommendations for Cystic Fibrosis carrier screening are very heterogeneous in Europe. A proposal of a carrier genetic test in the general population raises many questions. Health Technology Assessment (HTA) could offer a sound methodological basis for this evaluation. The aim of this work was to summarize the available evidence, using the HTA approach, on the genetic tests for Cystic Fibrosis carrier screening.

A systematic literature search was used to find the best available international and national evidence on genetics test for CF carrier screening. In this report, we specifically addressed the health problem of disease, description and technical characteristics of tests – its analytic and clinical validity, and clinical utility. Economic evaluation of different scenarios was synthesized from the literature. Ethical, organizational, and social aspects of CF and genetic screening were also considered.

Several screening strategies have been evaluated in the literature and screening options can be characterized by different timing, model and place of screening (2). The reported cost of a screening test ranged from EUR25 to EUR212 (3). Estimated life time cost of care for CF patients ranged from EUR291,048 to EUR1,105,452. Ethical analysis emphasized that the use of these tests is an advantage in terms of the acquisition of knowledge and of responsible management of choices, but at the same time raises many ethical questions. Social considerations reported among patients and their families an overall positive attitude toward population CF carrier screening.

The advances in the molecular genetics technology have made CF carrier testing reliable and affordable. The multidisciplinary approach of this HTA provided an evidence-based evaluation of genetic tests and offers a firm scientific background for the decision-makers to consider the implementation of a screening for Cystic Fibrosis carriers into the Italian health care system.