Pulmonary Arterial Hypertension drugs dispensation in ASL TO3: An epidemiological and economic excursus on the pathology [Article@La distribuzione di farmaci per l'Ipertensione Arteriosa Polmonare nell'ASL TO3: un excursus sulla patologia dal punto di vista epidemiologico ed economico]

Introduction. In recent years, ASL TO3 hospital pharmacy, which serves a demographic basin of about 600,000 residents, has sent numerous prescriptions on therapeutic plans for Rare Disease concerning drugs for pulmonary arterial hypertension (IAP) treatment. In this period the therapy approach has changed radically, both from the point of view of the available drugs, having selective therapeutic targets and of the prescription where there are more and more associations of therapies with 2 or 3 drugs. Materials and Methods. Data from the direct distribution (DD) information flows were collected and processed using software such as Microsoft Excel and Access to obtain epidemiological, prescriptive and expense information from 2004 to 2017. Furthermore, the prescription frequency of combination therapies from 2012 to 2017 was analyzed. Results. Patients average age is comparable with the literature data and the gender prevalence was higher in women in the obtained data. Patients were 6 in 2004 to become 57 in 2017. In total, 139 patients passed through direct distribution since 2004, of whom 39.6% died with an average survival of 2.8 years and the average age at the first dispensation was 56 years old. The prescriptive trend sees a progressive redistribution of consumption with an increase in the prescriptions of innovative drugs and the consequent reduction of drugs such as sildenafil and bosentan. Drugs association is a growing strategy and the collected data are aligned with the reference guidelines. Conclusions. Advances made in recent years in pharmacology and diagnosis fields have enabled diversified therapeutic options and improved patient quality life and survival. The possibility to have many therapeutic options with innovative drugs has increased spending in the last 5 years. With the sildenafil and bosentan patent expiry a reduction in spending on these drugs should be seen in the coming months and a new analysis will certainly be made.