ECONOMIC EVALUATION OF THE THERAPEUTIC PATHWAY WITH THE BARRX™ RADIOFREQUENCY ABLATION SYSTEM FOR BARRETT'S ESOPHAGUS, GASTRIC ANTRAL VASCULAR ECTASIA, AND RADIATION-INDUCED PROCTITIS IN THE ITALIAN NATIONAL HEALTH SERVICE
Author(s)
Michele Basile, MA, MSc1, Ilaria Valentini, PhD1, Ilaria Sciomenta, MSc2, Elena Maria Calosci, MEd, PharmD2, Francesca Borghetti, MSc3, Filippo Rumi, MA, MSc2, Eugenio Di Brino, MA, MSc1.
1Altems Advisory, Università Cattolica del Sacro Cuore, Rome, Italy, 2Altems Advisory,, Università Cattolica del Sacro Cuore, Rome, Italy, 3Value, Access & Policy Department, Medtronic Italia SpA, Milano, Italy.
1Altems Advisory, Università Cattolica del Sacro Cuore, Rome, Italy, 2Altems Advisory,, Università Cattolica del Sacro Cuore, Rome, Italy, 3Value, Access & Policy Department, Medtronic Italia SpA, Milano, Italy.
OBJECTIVES: The Barrx™ system, based on bipolar radiofrequency ablation (RFA), is recommended by international guidelines as first-line treatment for dysplastic Barrett’s Esophagus (BE) and is applied in Gastric Antral Vascular Ectasia (GAVE) and Chronic Radiation Proctitis (RP). To date, in Italy the use of RFA is performed in an inpatient setting, as no dedicated outpatient tariff is currently available. The primary objective is to quantify the overall cost of the care pathway with Barrx™, from the perspective of the Italian National Health Service (NHS).
METHODS: The study adopts an Activity-Based Costing (ABC) approach. The process included: systematic review using a PICO framework; mapping of key activities; multidisciplinary team for pathway validation; identification of activity-specific cost drivers; allocation of resources with reference to standardized institutional sources (national collective labour agreements, national procurement tenders, regional tariff nomenclators); calculation of unit costs, aggregation and sensitivity analysis
RESULTS: The literature documents, for BE, complete eradication rates of dysplasia and intestinal metaplasia >80-90%, with a significant reduction in progression to esophageal adenocarcinoma. For GAVE, RFA in patients refractory to the Argon Plasma Coagulation (APC) reduces bleeding episodes. For chronic RP, RFA controls bleeding in a high proportion of cases after only 1-2 sessions. The economic analysis is ongoing; the results of the ABC analysis, including costs for each phase of the pathway and for each of the three indications, will be available in the next months. The expected evidence includes: estimation of the cost of the pathway with Barrx™ and economic comparison with current and alternative pathways to assess the added economic value of Barrx™ in the outpatient setting; implications for the definition of an adequate outpatient reimbursement tariff within the Italian NHS.
CONCLUSIONS: To generate economic evidence is crucial to support reimbursement decisions and to plan diagnostic-therapeutic care pathways (PDTA), as well as optimize the healthcare resource allocation.
METHODS: The study adopts an Activity-Based Costing (ABC) approach. The process included: systematic review using a PICO framework; mapping of key activities; multidisciplinary team for pathway validation; identification of activity-specific cost drivers; allocation of resources with reference to standardized institutional sources (national collective labour agreements, national procurement tenders, regional tariff nomenclators); calculation of unit costs, aggregation and sensitivity analysis
RESULTS: The literature documents, for BE, complete eradication rates of dysplasia and intestinal metaplasia >80-90%, with a significant reduction in progression to esophageal adenocarcinoma. For GAVE, RFA in patients refractory to the Argon Plasma Coagulation (APC) reduces bleeding episodes. For chronic RP, RFA controls bleeding in a high proportion of cases after only 1-2 sessions. The economic analysis is ongoing; the results of the ABC analysis, including costs for each phase of the pathway and for each of the three indications, will be available in the next months. The expected evidence includes: estimation of the cost of the pathway with Barrx™ and economic comparison with current and alternative pathways to assess the added economic value of Barrx™ in the outpatient setting; implications for the definition of an adequate outpatient reimbursement tariff within the Italian NHS.
CONCLUSIONS: To generate economic evidence is crucial to support reimbursement decisions and to plan diagnostic-therapeutic care pathways (PDTA), as well as optimize the healthcare resource allocation.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
MT40
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Medical Technologies
Disease
Gastrointestinal Disorders