OBJECTIVES. With the emendment DGR n.1406-16/09/2020, the Veneto Regional Council assigned to Local Health Units (LHU) directors the health management, assistance plan and the related resources. Across January-July 2020, a LHU had the ceilings on total pharmaceutical expenditure of approximately € 990,000. To follow spending plans and guarantee care-access, the LHU utilized the Health-DB dashboard, a tool for monitoring indicators of prescription appropriateness, designed to combine therapeutic opportunities with economic sustainability.

METHODS. Health-DB dashboard, through the analysis of administrative databases, allows identifying areas of intervention of the prescription appropriateness indicators, the modality for their improvement ,and the consequent effects on pharmaceutical expenditure.

RESULTS. Through the analysis of LHU prescriptions, four drug categories had the most significant impact on expenditure [COPD medications, sartans, statins, proton-pump inhibitors(PPIs)], representing 40% of total spending. Five actions for prescription appropriateness improvement with related indicators were suggested: 1)patients in fixed association only where indicated (3.7% of those treated with inhaled-corticosteroids/long-acting-beta-agonist, 27.9% with statins/ezetimibe; 2) % of patients treated with lower-cost therapeutic alternatives (11.4% of those PPI-treated, 10.7% under sartans; 3)% patients who comply with the AIFA Notes (2.7% comply with Note 13, which defines the reimbursement criteria for lipid-lowering agents and 65.8% comply with Note 48, reporting the reimbursement criteria for PPIs); 4)% adherent patients(82.1% of lipid-lowering drugs-treated patients, 85.4% under antihypertensives, 51.3% under COPD medications); 5) % patients in secondary prevention (65.8% of patients with a previous cardiovascular event, 60.3% with COPD exacerbation). These actions and indicators were shared with medical specialists and the prescription appropriateness monitoring among general practitioners showed that the LHU’s pharmaceutical spending was reduced, saving € 115,000 compared to the assigned ceiling (cost reduction of € 1.1 million on a top of 24).

CONCLUSIONS. The Health-DB dashboard represents a valuable tool for achieving economic goals and, at the same time, for improving clinical practice.