A Regional Payers' Perspective

of the Explanation of the Italian System from

AIFA to local hospitals

Thomas Schael CEO ASL Magna Grecia Crotone - Commissionar ASL Napoli 2 Nord

Coordinator Pharmaclick Punto Salute

Advisor Healthcare Reform Regione Piemonte

Berlin, October 22nd 2013

Spending review 2010 (D.L. 78/2010):

Impact of 1,3 billion €

(Source: estimates IMS Health)

3

A very complex Supply Chain

4

Farmaceutica convenzionata

conventional distribution by local pharmacies with a reimbursement

contract referring to official AIFA prices with a possible discount

Distribuzione diretta

direct distribution of pharmaceuticals by public health authorities and

hospitals bought directly from the producer

Distribuzione in nome e per conto

distribution of pharmaceuticals by local pharmacies bought directly from

the producer by local health authorities paying a fixed service fee for each

unit distributed by the pharmacies

New models for the distribution of pharmaceuticals in Italy

The Public Health Authority Province of Naples

“ASL Napoli 2 Nord”

•Over 1 million inhabitants

•32 Cities and the Irlands of

Ischia and Procida

•Territorry of 450 square km

•5 public hospitals and

5 private hospitals

•4200 employees and 1800

contracted GPs

ASL Napoli 2 Nord: 223 privat pharmacies

ASL Napoli 2 Nord: public pharmacies and hospitals

10 Farmacia distrettuale

4 Farmacia ospedaliera

Project

A.R.Ca.

Pharmaceutical spending control project

Logical flow and datawarehouse

Deviation Analysis

Alert

The people involved

10

Ipertension (C09)

% ddd Losartan 2010 ASL Napoli 2 Nord

ASL Napoli 2 Nord

usage of Losartan in different districts in 2010

Reduction of the pharmceutical spending

ASL Napoli 2 Nord 2010

-€ 20 milioni in 9 months

-€ 40 per citizen per year

= 14%

Next challenge: Regione Piemonte

Source: AIFA Rapporto OSMED gennaio-Settembre 2012

Objectives

- 10% spending on territorial pharma - 5% spending on hospital pharma

Cost Earnings - €96 million

Period 2013-2015