Harnessing pharmaceutical innovation for anti-cancer drugs: Some findings from the Italian regions

Background: Governing the provision of innovative drugs is unanimously recognized as a key factor in steering the future of health care systems, by jointly affecting health outcomes and financial sustainability. Aim of the study: This paper describes the recent reforms in Italy governing the provision of innovative oncological drugs, with a focus on the different strategies implemented by the regions. It provides some preliminary findings about economic performance potentially associated with different governance models. Methods: We conducted a qualitative study based on 26 face-to-face semi-structured interviews with the Regional Directors of the pharmaceutical sector of the 13 regions involved in the study. The interviews were analysed to detect the various tools regions have adopted to manage prescriptions of innovative oncological drugs and different regional models were mapped. Additionally, we collected relevant information on the regional economic outcomes from national open data sources. Results: The 13 Italian regions strongly differ in how they apply national instruments and in how they devise regional governance tools. Analysis of the main economic indicators highlights that there is no direct relationship between strategies applied and performance achieved, although some preliminary results suggest a potential association between certain clinical governance models and different appropriateness performances.