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.