Aspetti organizzativi e gestionali legati all’utilizzo di etanercept nel trattamento dell’Artrite Reumatoide, in Health Technology Assessment dell'Etanercept nel trattamento dell'artrite reumatoide

[Autom. eng. transl.] Rheumatoid arthritis (AR) is a chronic pathology with a high social and health impact, due to both its progressive and disabling character and the high direct and indirect social costs. The chronic and debilitating aspect of this disease, which negatively influences different sectors of daily, working and social life, requires a correct diagnostic approach and an early therapeutic intervention. In order to guarantee high standards of care, continuum of care and fairness of access to treatments, it is necessary to promote and pursue, at various institutional and decisional levels, a series of actions aimed at: ₋ Inserting into Regional Health Planning, as specific health objective, the improvement of social and health assistance provided to people suffering from rheumatic diseases. Ire Define national / regional guidelines aimed at ensuring the diagnosis and treatment of RA in a timely and effective manner, as well as management, institutional integration and the various professional figures involved. ₋ Activate a national registry of systemic rheumatic diseases, a tool already active for a long time in other countries and able to provide reliable epidemiological data. ₋ • Guarantee the timely access by people affected by AR to indispensable pharmacological therapies throughout the national territory, with particular regard to the innovative ones (biological drugs), also through a specific monitoring activity by the Italian Drug Agency ( AIFA). It is necessary to overcome the current regional differences (in particular in regions with huge deficits in the health sector) of access to medicines. It is necessary to simplify access to innovative pharmacological therapies (biological drugs) by patients, expanding the number of facilities and the range of health professionals authorized to prescribe and deliver the aforementioned drugs. An example in this sense could be represented by the extension to territorial rheumatologist specialists of the possibility of prescribing biological drugs. ₋ To guarantee, with a specific planning act, the widespread and homogeneous presence, throughout the regional territory, of rheumatology services, with particular regard to territorial ones and to strengthen the network of rehabilitation services. ₋ To promote, through telematic solutions and throughout the region, the "network" organization of social and health care services (network of diagnostic services, network of specialists, networks of assistance structures, etc.), in such a way as to share information (data), integrate and enhance individual skills, transfer scientific knowledge. ₋ Promote national information campaigns in order to facilitate the early diagnosis of rheumatic diseases and in particular AR. The impairment of the quality of life, consequent to AR, constitutes an element to be analyzed as a factor conditioning patients' requests for assistance and capable of influencing compliance with regard to treatment. As confirmed by the available scientific literature, the health status and quality of life of people with RA, lower than baseline compared to those of the healthy population, significantly improve following etanercept therapy, both from an emotional and a physical point of view . In particular, the combined treatment with etanercept and methotrexate allows a greater improvement in the quality of life of patients compared to the administration of methotrexate alone.