if this message does not display correctly, click here | Table of Contents Andrea Marcellusi, University of Rome, Tor Vergata - Centre for International Studies on Economic Growth (CEIS), University of Rome I
Raffaella Viti, University of Rome, Tor Vergata - Centre for International Studies on Economic Growth (CEIS)
Francesco Damele, Health Economics & Outcomes Research Manager HEMAR Manager Infectious Diseases
Calogero Cammà , University of Palermo
Gloria Taliani, Università La Sapienza
Francesco Saverio Mennini, University of Rome, Tor Vergata - Centre for International Studies on Economic Growth (CEIS), Kingston University - School of Accounting and Finance Alessio D'Amato, University of Rome, Tor Vergata - Faculty of Economics
Edilio Valentini, Universita D'Annunzio
Mariangela Zoli, University of Rome Tor Vergata Leonardo Becchetti, University of Rome, Tor Vergata - Faculty of Economics
Germana Corrado, University of Rome, Tor Vergata - Department of Economics and Finance
Vittorio Pelligra, Universita di Cagliari - Department of Economics
Fiammetta Rossetti, University of Rome II | |
CEIS: CENTRE FOR ECONOMIC & INTERNATIONAL STUDIES
Vincenzo Atella - Director "Early Treatment in HCV: Is it a Cost-Effective Option from the Italian Perspective?" 
CEIS Working Paper No. 370 ANDREA MARCELLUSI, University of Rome, Tor Vergata - Centre for International Studies on Economic Growth (CEIS), University of Rome I
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RAFFAELLA VITI, University of Rome, Tor Vergata - Centre for International Studies on Economic Growth (CEIS)
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FRANCESCO DAMELE, Health Economics & Outcomes Research Manager HEMAR Manager Infectious Diseases
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CALOGERO CAMMÀ, University of Palermo
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GLORIA TALIANI, Università La Sapienza
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FRANCESCO SAVERIO MENNINI, University of Rome, Tor Vergata - Centre for International Studies on Economic Growth (CEIS), Kingston University - School of Accounting and Finance
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Background: The aim of this study is to perform an economic analysis to estimate the cost-utility of the early innovative therapy in Italy for managing HCV-infected patients.
Methods: The incremental cost-utility analysis was carried out to quantify the benefits of the early treatment approach in HCV subjects. A Markov simulation model including direct and indirect costs and health outcomes was developed from Italian National Healthcare Service and societal perspective. 5,000 Monte Carlo simulations were performed on two distinct scenarios: Standard of Care (SoC) which includes 14.000 Genotype 1 patients in Italy treated with innovative interferon-free in the Fibrosis stage 3 and 4 (F3-F4) vs Early-treatment Scenario (ETS) where 2.000 patients were additionally treated with simeprevir plus peginterferon and ribavirin in the Fibrosis stage 2 (F2) (based on AIFA reimbursement criteria). A systematic literature review was carried out to identify epidemiological and economic data, which were subsequently used to inform the model. Furthermore, a one-way probabilistic sensitivity was performed in order to measure the relationship between the main parameters of the model and the cost-utility results.
Results: The model shows that, in terms of Incremental Cost Effectiveness Ratio (ICER) per QALY gained, ETS appeared to be the most cost-effective option compared from both perspective Societal (ICER = €11.396) and NHS (ICER = €14.733) over a time horizon of 10 years. The cost-effectiveness of ETS is more sustainable as it extends the time horizon analysis (ICER = € 6.778 per QALY to 20 years and € 4,474 per QALY to 30 years). From the societal perspective the ETS represents the dominant option at a time horizon of 30 years. If we consider the sub-group population of treated patients (16.000 patients of which 2.000 not treated in the SoC), the ETS scenario was dominant after only 5 years horizon and cost-effective at 2 years of simulation. The one-way sensitivity analysis on the main variables confirmed the robustness of the model for the early-treatment approach.
Conclusion: In conclusion, our model represents a tool for policy makers and health care professionals provide information on the cost-effectiveness of early-treatment approach in patients HCV-infected in Italy. Starting innovative treatment earlier regimens keeps HCV-infected patients in better health and reduces the incidence of HCV related events; this generating a gain both in terms of health of the patients and correct resource allocation. "Tradable Quotas Taxation and Market Power"
CEIS Working Paper No. 371 ALESSIO D'AMATO, University of Rome, Tor Vergata - Faculty of Economics
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EDILIO VALENTINI, Universita D'Annunzio
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MARIANGELA ZOLI, University of Rome Tor Vergata
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We show how corrective taxation can improve the efficiency properties of tradable quotas systems affected by market power. Indeed, when only a subset of firms are price takers while the remaining firms enjoy market power, we show that, if the regulator sets an ad hoc taxation on firms' traded quotas, cost effectiveness can be restored without necessarily driving dominant firm(s) net demand to zero. Cost effectiveness with market power and quotas taxation implies some cost in terms of tax revenue that, however, can be justified from a social welfare perspective. Moreover, all firms may result to be better off when the corrective taxation is implemented. "Happiness and Preferences in a Legality Social Dilemma: Comparing the Direct and Indirect Approach"
CEIS Working Paper No. 372 LEONARDO BECCHETTI, University of Rome, Tor Vergata - Faculty of Economics
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GERMANA CORRADO, University of Rome, Tor Vergata - Department of Economics and Finance
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VITTORIO PELLIGRA, Universita di Cagliari - Department of Economics
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FIAMMETTA ROSSETTI, University of Rome II
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We investigate players’ preferences in a multiplayer prisoner’s dilemma by comparing results from a direct (satisfaction based) and an indirect (choice based) approach. Both approaches provide strong evidence of preference heterogeneity, with players who cooperate above median being less affected in their choice by monetary payoffs vis-à -vis the public good component. The combination of a legality frame plus a conformity information design reduces further the relative preference (satisfaction) for the non-cooperative choice for such players. Our findings support the hypothesis that (part of the) players have, in addition to the standard self-interest component, an other-regarding preference argument that is further satisfied in the legality frame plus conformity design. | | ^top
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