Key findings
- The multi-level structure of HTA in Italy has not yet provided a full co-ordination and harmonisation of practices and outcomes across the country. Many of the regions with the most developed HTA systems are better organised and more efficient than the others, with the result that they attract patients from other regions as well. This consequently exacerbates inequality of access to services and technologies.
- Regional programmes are frequently constrained by a lack of sufficient data, which undermines transparency. The feedback from the regional level—not only to national agencies but also to other regions—is not adequate.
- Italy has taken the lead in Europe in experimenting with a range of innovative financing approaches, as well as introducing a greater emphasis on outcomes. The country has been ahead of other European countries in establishing managed entry agreements (MEAs) with pharmaceutical companies that share risk and allow for the greater collection of clinical evidence once new drugs are already in use.
- Although a significant percentage of MEAs continue to be shaped by cost considerations, a growing number reflect efforts to measure cost-effectiveness and outcomes.