Evidence map›Paper›PMID 41982932›Full record

ArticleGlobal & regional health technology assessment

Italian Medicines Agency's reform and time until pricing and reimbursement decisions: a time-to-event analysis.

Gian Marco Raspolini, Bruno Federico, Mario Cesare Nurchis, Gianfranco Damiani, Raffaella Cocciolo, Paola Turella, Daniela Pilunni, Pierluigi Navarra

Abstract read
In one paragraph

Article in Global & regional health technology assessment. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Gian Marco RaspoliniSection of Hygiene, Department of Health Science and Public Health, Università Cattolica del Sacro Cuore, Rome - Italy.ORCID https://orcid.org/0000-0002-7983-5814
Bruno FedericoDepartment of Human Sciences, Society and Health, University of Cassino and Southern Lazio, Cassino - Italy.ORCID https://orcid.org/0000-0002-8629-4366
Mario Cesare NurchisSection of Hygiene, Department of Health Science and Public Health, Università Cattolica del Sacro Cuore, Rome - Italy.ORCID https://orcid.org/0000-0002-9345-4292
Gianfranco DamianiSection of Hygiene, Department of Health Science and Public Health, Università Cattolica del Sacro Cuore, Rome - Italy.ORCID https://orcid.org/0000-0003-3028-6188
Raffaella CoccioloIntexo Società Benefit, a ProductLifeGroup Company, Rome - Italy.
Paola TurellaIntexo Società Benefit, a ProductLifeGroup Company, Rome - Italy.
Daniela PilunniFarmacia Prodotti Sperimentali, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome - Italy.
Pierluigi NavarraSection of Pharmacology, Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore - Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome - Italy.ORCID https://orcid.org/0000-0002-4424-650X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: The duration of pricing and reimbursement (P&R) negotiations is a key performance indicator for medicines agencies in universal health coverage systems. In early 2024, the Italian Medicines Agency (AIFA) underwent a major reform, including the merging of the previous Scientific-Technical Committee and Price and Reimbursement Committee into a single Scientific and Economic Committee. This study evaluates the reform's impact on time to P&R determinations for new medicines in Italy. Methods: A time-to-event analysis was conducted on 139 new chemical entities authorized by the European Commission (EC) between February 2021 and December 2023. The primary outcome was the time from marketing authorization (MA) to publication of AIFA's P&R determination. Kaplan-Meier curves and Cox proportional hazards models were used to compare reclassification hazards between pre- (before March 2024) and post-reform groups of medicinal products, based on a fixed separation date, adjusting for antineoplastic therapeutic area and pharmaceutical company size. Four sensitivity analyses tested the robustness of the results. Results: The multivariate Cox model, adjusting for antineoplastics, products from major corporations, and orphan medicines, showed that the reform was associated with an 84% increase in reclassification hazards (HR = 1.84, 95% CI 1.20-2.82, p = 0.005). Sensitivity analyses corroborated these findings, showing even greater improvements when focusing on national evaluation timeframes (HR = 11.57 and HR = 3.91). Conclusion: The consolidation of separate committees into a unified structure, as a part of the 2024 AIFA reform, was accompanied by accelerated P&R negotiations for new medicines in Italy, demonstrating that structural optimization of health technology assessment processes may enhance system efficiency.

Indexed as

AIFAHealth Services AccessibilityPharmaceutical policyPharmaceutical preparationsPricing and reimbursementSurvival Analysis

Identifiers

PMID41982932
PMCPMC13071805

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.