Better management of the patient with age-related maculopathy (AMD, from the English Age-related macular degeneration) is possible by acting on 4 strengths: gaining awareness of the current management of patients with maculopathy and the related economic impact and social by all the stakeholders involved; build integrated care by reducing inequalities; promote conditions of maximum appropriateness (such as therapeutic adherence) and measure the impact of healthcare investments based on the value generated within the process of taking charge. This is highlighted by the analysis on the cost of the newly widespread pathology conducted by the High School of Economics and Management of Health Systems – Faculty of Economics on the Rome campus of the Catholic University (Altems), with the unconditional support of Roche Italy.
“The report brings out clear needs related to the economic and investment sphere. On the one hand, it is essential to promote an increasingly integrated strategic planning of investments between the health and social spheres. On the other hand, it is necessary to measure the impact of the healthcare investment based on the value generated within the process of taking charge”, explains Americo Cichetti, full professor of Business Organization at the Faculty of Economics of the Catholic University and director of Altems speaking at the online webinar ‘Age-related macular degeneration, emerging needs and key health policies for value-based care’.
The survey results show that “management models impact based on the level of adherence. With an adherence of around 50%, the effectiveness is reduced – observes Cicchetti – With the current management model, the economic burden that can be associated with a single patient is 60 thousand euros, of which the social costs (indirect and out of pocket) they account for 60% (40,000 euros). Pharmacological treatment follow-up weighs less than 17%. If we optimize the therapeutic process with technologies capable of facilitating adherence – specifies the expert – the expenditure drops to 36 thousand with the pharmacological one increasing, in percentage, but due to the drastic reduction of the social one. The saving of 24,000 euros per patient is extremely significant”.
As Stanislao Rizzo, full professor of diseases of the visual system at the Faculty of Medicine and Surgery of the Catholic University and Director of the UOC of Ophthalmology of the Agostino Gemelli Irccs University Hospital Foundation underlines: “A process of taking charge, if declined inappropriately, not only does it lead to economic inefficiencies but it contributes negatively to the quality of life of patients and caregivers and their associated costs. In fact, the report confirms the importance of ensuring conditions of maximum adherence to therapies in order to guarantee clinical and economic appropriateness, and reminds us of the importance of guaranteeing integrated assistance to the patient through management models focused on early diagnosis and on therapeutic appropriateness”.
Assia Andrao, president of Retina Italia onlus adds: “Considering what emerged from the Altems research and that almost all patients with maculopathy live with at least one further comorbidity, we believe it is essential to ensure the active participation of patients in the research and development of load. This involvement – he continues – must be operated with the awareness that the patient and his caregiver are the only ones who can give a point of view on the pathology, as experienced firsthand. Furthermore, within a pathology characterized by frequent visits to the hospital for check-ups and treatments, it is essential to understand how much time the patient spends within the structures, even more so if this has an impact on the total cost of taking care of the patient, and on the psychophysical commitment of the patient”.
By identifying the points on which to leverage for a better management, the survey leaves open the possibility of identifying new solutions for the future. “The photograph presented by this study highlights how important it is to acquire awareness of the current management of patients with maculopathy and the related economic and social impact. It is necessary to define political-institutional guidelines aimed at improving patient care: assistance should ensure continuity between hospital and territory, conditions of maximum clinical and organizational appropriateness, continuous and participatory dialogue between all stakeholders and ministries involved”, he comments Senator Elisa Pirro, member of the Senate Social Affairs Commission.
“The current scenario shows us how maculopathies and their social and economic burden, for the patient and the caregiver, are still little recognized. As clearly emerges from Altems’ analysis, these are chronic pathologies not yet recognized as such. Precisely for this reason, the assistance that should be provided to these patients should have clear and effective legislative guidelines. With this awareness we will work hard to build a welfare director that better meets the needs of all the parties involved”, concludes the honorable Simona Loizzo, member of the Social Affairs Commission of the Chamber.
