title: HCV novel therapeutic regimens in Wonderland: A budget impact analysis in the Lombardy Region.
abstract: BACKGROUND
  The advent of new HCV drugs has generated widespread economic concerns, particularly within the Italian setting, characterized by continuous linear cuts and spending review actions. The overall trade-off between investments and savings needs an in depth analysis.
  
  
  OBJECTIVE
  The study aimed to estimate the budget impact of the introduction of the novel drugs approved during the year 2015, compared with the historical situation based on the different treatment options available prior to 2015.
  
  
  METHODS
  A three-year budget impact model was developed, taking into consideration the Lombardy Region (Northern Italy) Health Service perspective. The degree of liver fibrosis, genotypes, presence of only HCV or HIV/HCV co-infections, presence or absence of sustained virological response, and direct healthcare total costs were the variables of the model.
  
  
  RESULTS
  With the introduction of the novel regimens, a higher number of HCV patients achieved a sustained virological response (+20%). Further analysis showed that an investment in innovative technologies would have given the Regional System significant economic savings within the 36-month period (-6.64%/-7.15%).
  
  
  CONCLUSIONS
  Treating HCV-infected persons in the Lombardy Region with the new drugs would reduce healthcare expenditure on this specific disease, in each forecast implemented, thus reducing the economic burden of the pathology.
authors.affiliation: Centre for Research on Health Economics, Social and Health Care Management, LIUC - Carlo Cattaneo University, Castellanza, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Garagiola
authors.affiliation: Centre for Research on Health Economics, Social and Health Care Management, LIUC - Carlo Cattaneo University, Castellanza, Italy. Electronic address: lferrario@liuc.it.
authors.forename: Lucrezia
authors.initials: L
authors.lastname: Ferrario
authors.affiliation: Centre for Research on Health Economics, Social and Health Care Management, LIUC - Carlo Cattaneo University, Castellanza, Italy; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Davide
authors.initials: D
authors.lastname: Croce
authors.affiliation: Infectious Diseases Department, ASST Valle Olona, Busto Arsizio, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Menzaghi
authors.affiliation: Infectious Diseases Department, ASST Valle Olona, Busto Arsizio, Italy.
authors.forename: Tiziana
authors.initials: T
authors.lastname: Quirino
authors.affiliation: Department of Infectious Diseases, Fatebebefratelli Sacco Hospital, Milan, Italy; School of Clinical Medicine, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Giuliano
authors.initials: G
authors.lastname: Rizzardini
authors.affiliation: Centre for Research on Health Economics, Social and Health Care Management, LIUC - Carlo Cattaneo University, Castellanza, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Foglia
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D060085:Coinfection / Q000188:drug therapy; D003362:Cost-Benefit Analysis; D019091:Critical Pathways / Q000191:economics*; D016527:Drug Costs / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000188:drug therapy*; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007558:Italy; D008103:Liver Cirrhosis / Q000188:drug therapy*
chemical_list: D000998:Antiviral Agents
keywords: Budget impact analysis (BIA); Economic savings; HCV infection; Northern Italy Region