药物经济学：开放获取

Aims: This study aimed to identify all Health Technology Assessment (HTA) reports published by HTA bodies assessing FreeStyle Libre and consider how differences in methodologies contribute to variation in decision-making.

Methods: The literature search conducted in October 2018 targeted 158 HTA body websites in 45 countries. Data were extracted and results were analysed under four themes to assess clinical and economic evidence, engagement with stakeholders and conclusions and recommendations.

Results: This analysis included 17 HTA reports. Despite uncertainties in the evidence, a majority concluded FreeStyle Libre reduces the frequency and time in hypoglycaemia and improves patient satisfaction compared to self-monitoring blood glucose (SMBG). Across ten HTAs that considered patient and healthcare professional (HCP) feedback, there was strong support for the adoption of FreeStyle Libre. Of 3 HTA bodies that conducted costeffectiveness, two concluded FreeStyle Libre is cost-effective and one that it was cost-effective amongst patients with high test frequencies. In 5 that conducted budget impact analysis, all concluded FreeStyle Libre is more expensive than SMBG and 3 noted FreeStyle Libre may be cost-saving amongst patients with a high-test frequency. Methodologies varied widely in respect to the approach to quality assessment, the assessment of early evidence and how stakeholder feedback is incorporated.

Conclusion: Different methodologies led to variation in conclusions. Despite this most concluded that compared to SMBG, FreeStyle Libre reduces the frequency and time in hypoglycaemia, and is likely cost-effective or cost saving in certain patient populations. The HTA reports that HCP and patient groups support adoption of FreeStyle Libre.

Background: Several studies estimates that in industrialized country retinal diseases such as macular degeneration (MD) and diabetic retinopathy (DR), have a particularly high prevalence, causes deterioration in quality of life, with significant social and economic consequences.

This study analyses the data of the Observatory on Legal Blindness to estimate, using real-world data, the average number of beneficiaries and the costs related to Supplementary Security Income (SSI) and attendance allowance (AA) for people with specific forms of DR and MD.

Methods: We used data from the National Institute of Social Security (INPS) database regarding disability insurance awards (DIAs) for SSI and the AA for totally blind (TB) and partially sighted (PB) people from 2012 to 2016.

Results: For MD, we estimated yearly averages of 11,600 AA beneficiaries and 9,100 SSI beneficiaries, with mean costs of €53.9 million and €30.1 million, respectively. For DR, we estimated yearly averages of 3,200 AA beneficiaries and 2,500 SSI beneficiaries, with mean costs of €16.7 million and €8.2 million, respectively. Analyses of the DIAs showed a slight increase in the number PB individuals affected by DM and TB individuals affected by RD and DM.

Conclusions: According to this study, MD and DR involve significant economic and social costs due to their chronicity. This is the first study to estimate the welfare costs of these two groups of visual diseases using data from the evaluations provided by the medical commissions and the benefits paid by the INPS.