title: [Statin therapy: cost-effectiveness and evaluation of evidence as criterium for improving expenditure within the National Health Program].
abstract: The choice is difficult in medicine. But individual physicians and patients must make medical decisions rather than organizations or pharmaceutical companies. The choice concerns the transparency of the decision-making process (evidence based medicine), and mistrust of the methods used in cost-effectiveness analysis. Medicare's policy of paying for any medical advance that has positive benefits, regardless of its costs, is un-sustainable. Cost-effectiveness information may assume a more important role in future coverage decisions with regard to outpatient prescription drugs, but at the private level, rather than at the national one. Functional equivalence of drugs reflects a reference-pricing technique applied to a therapeutic category--reimbursement for compounds of similar efficacy within a therapeutic class set to the lowest-priced product in the class. Essentially, a standard of functional equivalence applies a cost-effectiveness principle: assuming that alternative interventions are equivalent, one should not pay more for one of them.
authors.affiliation: Dipartimento di Farmaceutico, Ospedale Mazzoni, Ascoli Piceno.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Magi
authors.forename: Pasqualino
authors.initials: P
authors.lastname: Sforza
authors.forename: Stefania
authors.initials: S
authors.lastname: Rafaiani
authors.forename: Paolo
authors.initials: P
authors.lastname: Settembri
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Morosini
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000191:economics / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000191:economics / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000191:economics / Q000627:therapeutic use; D000924:Anticholesteremic Agents / Q000191:economics* / Q000627:therapeutic use*; D003324:Coronary Artery Disease / Q000150:complications / Q000188:drug therapy* / Q000191:economics*; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D004359:Drug Therapy, Combination; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007558:Italy; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics*; D009765:Obesity / Q000150:complications; D017035:Pravastatin / Q000191:economics* / Q000627:therapeutic use*; D013967:Thyroiditis, Autoimmune / Q000150:complications
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000924:Anticholesteremic Agents; D017035:Pravastatin