ClinicoEconomics and Outcomes Research (Jun 2021)

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

  • Torre E,
  • Colombo GL,
  • Di Matteo S,
  • Martinotti C,
  • Valentino MC,
  • Rebora A,
  • Cecoli F,
  • Monti E,
  • Galimberti M,
  • Di Bartolo P,
  • Gaggioli G,
  • Bruno GM

Journal volume & issue
Vol. Volume 13
pp. 503 – 518

Abstract

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Enrico Torre,1 Giorgio Lorenzo Colombo,2 Sergio Di Matteo,3 Chiara Martinotti,3 Maria Chiara Valentino,3 Alberto Rebora,1 Francesca Cecoli,1 Eleonora Monti,1 Marco Galimberti,4 Paolo Di Bartolo,5 Germano Gaggioli,6 Giacomo Matteo Bruno2 1Endocrinology Diabetology and Metabolic Diseases Unit - ASL3, Genoa, Italy; 2Department of Drug Sciences, University of Pavia, Pavia, Italy; 3S.A.V.E. Studi Analisi Valutazioni Economiche S.r.l., Health Economics & Outcomes Research, Milan, Italy; 4DP Trade SA, Lugano, Switzerland; 5Diabetes Center of Ravenna, Romagna Diabetes Clinical Network, Romagna Local Health Authority, Ravenna, Italy; 6Cardiology Unit Villascassi Hospital - ASL3, Genoa, ItalyCorrespondence: Giorgio Lorenzo ColomboDepartment of Drug Sciences, School of Pharmacy, University of Pavia, Pavia, ItalyEmail [email protected]: 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: 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: 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: 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.Keywords: COVID-19, diabetes type II, diabetic complications, quality of life, economic impact

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