Economic Impact of COVID-19 Lockdown on Italian NHS: Focus on Diabetes Mellitus.

COVID-19 diabetes type II diabetic complications economic impact quality of life

Journal

ClinicoEconomics and outcomes research : CEOR
ISSN: 1178-6981
Titre abrégé: Clinicoecon Outcomes Res
Pays: New Zealand
ID NLM: 101560564

Informations de publication

Date de publication:
2021
Historique:
received: 30 03 2021
accepted: 19 05 2021
entrez: 24 6 2021
pubmed: 25 6 2021
medline: 25 6 2021
Statut: epublish

Résumé

In Italy, the adoption of a total lockdown has generated almost total suspension of outpatient visits except for emergencies. Even after lockdown, the pandemic fear created additional barriers to access the health services. The aim of our study is to evaluate the economic impact of the lockdown for COVID-19 on public health in Italy, focusing on its effects on diabetic population. We analyzed the impact of the lockdown on excess mortality and morbidity in the Italian diabetic population during 2020. The analysis was divided into several steps: a quantification of specialist visit reduction, the calculation of excess mortality in the diabetic population, the economic evaluation of the slowdown in the use of innovative diabetic therapies. Furthermore, the impact of the lockdown on the reduction of procedures and follow-up visits in diabetic population was evaluated. The overall impact of the pandemic and lockdown effects on costs and quality of life was then calculated. During 2020, a drop of 28% in patient access has been observed. Diabetic patients recorded a twice higher mortality value compared to general population (20.4% vs 10.2%). The analysis of market data revealed a slowdown in consumption of new antidiabetic therapies (-14%, 27% vs 41%). We estimated an expense of €26.6 million for NHS and a loss of 257 utilities in diabetic population due to the missed benefits related to slowdown in innovative antidiabetic drugs use and non-optimal follow-up and control of diabetes complications. In simulation scenarios, we also estimated an overall expenditure ranging from €38.7 to 94.0 million and a loss of 294-836 utilities. Diabetic population paid a high tribute to pandemic and lockdown, both in terms of number of deaths and burden of diabetic complications, together with an overall deterioration of quality of life.

Sections du résumé

BACKGROUND BACKGROUND
In Italy, the adoption of a total lockdown has generated almost total suspension of outpatient visits except for emergencies. Even after lockdown, the pandemic fear created additional barriers to access the health services. The aim of our study is to evaluate the economic impact of the lockdown for COVID-19 on public health in Italy, focusing on its effects on diabetic population.
MATERIALS AND METHODS METHODS
We analyzed the impact of the lockdown on excess mortality and morbidity in the Italian diabetic population during 2020. The analysis was divided into several steps: a quantification of specialist visit reduction, the calculation of excess mortality in the diabetic population, the economic evaluation of the slowdown in the use of innovative diabetic therapies. Furthermore, the impact of the lockdown on the reduction of procedures and follow-up visits in diabetic population was evaluated. The overall impact of the pandemic and lockdown effects on costs and quality of life was then calculated.
RESULTS RESULTS
During 2020, a drop of 28% in patient access has been observed. Diabetic patients recorded a twice higher mortality value compared to general population (20.4% vs 10.2%). The analysis of market data revealed a slowdown in consumption of new antidiabetic therapies (-14%, 27% vs 41%). We estimated an expense of €26.6 million for NHS and a loss of 257 utilities in diabetic population due to the missed benefits related to slowdown in innovative antidiabetic drugs use and non-optimal follow-up and control of diabetes complications. In simulation scenarios, we also estimated an overall expenditure ranging from €38.7 to 94.0 million and a loss of 294-836 utilities.
CONCLUSION CONCLUSIONS
Diabetic population paid a high tribute to pandemic and lockdown, both in terms of number of deaths and burden of diabetic complications, together with an overall deterioration of quality of life.

Identifiants

pubmed: 34163191
doi: 10.2147/CEOR.S313577
pii: 313577
pmc: PMC8213950
doi:

Types de publication

Journal Article

Langues

eng

Pagination

503-518

Informations de copyright

© 2021 Torre et al.

Déclaration de conflit d'intérêts

This project was conducted with the support of AstraZeneca. GLC, SDM, GMB, CM and MCV are employees of S.A.V.E. S.r.l and consultants for different pharmaceutical companies. ET, AR, FC, EM, and GG are affiliated with ASL3. ET, in the last 3 years, has received consultancy and/or speaking fees and research grants from AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly, GSK, Janssen, Johnson & Johnson, MSD Italy, Novo Nordisk, Sanofi and Takeda. The authors report no other conflicts of interest in this work.

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Auteurs

Enrico Torre (E)

Endocrinology Diabetology and Metabolic Diseases Unit - ASL3, Genoa, Italy.

Giorgio Lorenzo Colombo (GL)

Department of Drug Sciences, University of Pavia, Pavia, Italy.

Sergio Di Matteo (S)

S.A.V.E. Studi Analisi Valutazioni Economiche S.r.l., Health Economics & Outcomes Research, Milan, Italy.

Chiara Martinotti (C)

S.A.V.E. Studi Analisi Valutazioni Economiche S.r.l., Health Economics & Outcomes Research, Milan, Italy.

Maria Chiara Valentino (MC)

S.A.V.E. Studi Analisi Valutazioni Economiche S.r.l., Health Economics & Outcomes Research, Milan, Italy.

Alberto Rebora (A)

Endocrinology Diabetology and Metabolic Diseases Unit - ASL3, Genoa, Italy.

Francesca Cecoli (F)

Endocrinology Diabetology and Metabolic Diseases Unit - ASL3, Genoa, Italy.

Eleonora Monti (E)

Endocrinology Diabetology and Metabolic Diseases Unit - ASL3, Genoa, Italy.

Marco Galimberti (M)

DP Trade SA, Lugano, Switzerland.

Paolo Di Bartolo (P)

Diabetes Center of Ravenna, Romagna Diabetes Clinical Network, Romagna Local Health Authority, Ravenna, Italy.

Germano Gaggioli (G)

Cardiology Unit Villascassi Hospital - ASL3, Genoa, Italy.

Giacomo Matteo Bruno (GM)

Department of Drug Sciences, University of Pavia, Pavia, Italy.

Classifications MeSH