Taking decisions on expenditure for high-cost drugs at the regional level: a model for evaluating the overall impact of Trastuzumab in the Veneto Region of Italy

Introduction Cost-effectiveness analysis provides a ratio that indicates the value created per unit of money by a given therapy but says nothing about the total expected costs or net health and social impact of this therapy in a particular population of interest. Objective The main objective of this study is to define a methodology to calculate the effects of interventions from a local perspective. This will help determine parameters that provide information about resource planning and management to local decision makers. Methods The described methodology calculates four indicators using local demographic and epidemiological data and a Markovian decision tree approach. Results The method was applied to evaluate the economic, health and social impact of introducing a new cancer drug, Trastuzumab, for the early treatment of breast cancer in the Veneto Region of Italy. Discussion The indicators described in this study allow public policy makers to clearly understand the benefits and costs of a particular health intervention in a local population and to compare it with other strategies.