Il caso studio del Mesotelioma in Piemonte: potenziale riduzione dei costi attraverso clinical trials sponsorizzati

In Italy asbestos is a big problem, due to its enormous use in the past centuries. This issue is related to the hazardous effects of this mineral on human health, related to occupational, familiar or environmental exposure to asbestos fibres. The work focus on Piedmont, since in this Italian region the cost in terms of human lives has been, and it continues to be, particularly relevant. In fact, the asbestos mine of San Vittore in Balangero-Corio was the biggest one in Europe and one of the biggest all over the World, and in Casale Monferrato there was the biggest Italian branch of the Eternit, producing cement-asbestos products. From the early XX century, it begun to exist a belief of correlation between asbestos and a dramatic sequence of pathologies. At the end of the 1970s, focused investigations gave the epidemiological confirm of that. Finally, in 1992, the Italian law n.257 banned the production and the trade of man-made products containing asbestos, with the suspesion of all import, extraction and use activities. According to the World Health Organization estimates, more than 107,000 deaths each year are attributable to occupational exposure to asbestos. One of the main pathologies asbestos-related is mesothelioma. Mesothelioma is a cancer that attacks the lungs and the abdomen. Researchers spent decades in investigating its causes to discover that the primary culprit is exposure to asbestos. According to the National Register for Mesothelioma (ReNaM), in 2012 in Piedmont, the diagnosed cases of mesothelioma were more than 800, and this number was expected to increase until 2015 and then to stabilize, due to long latency period of this cancer. Now-a-days there are no available treatments that ensures a long life expectancy for these patients. Standard treatments for mesothelioma concern systematic chemotherapy, and the estimated mean cost for each treatment of naïve patients, is more than 6.000 euros. The purpose of the work is to estimate the overall drug cost for the standard treatment of mesothelioma patients for the Piedmontese Regional Healthcare System, and to estimate the potential drug cost savings if all of them would apply to the clinical trials of II-III phase, with free drugs sponsored by pharmaceutical companies. To conclude, taking into consideration also the drawbacks of clinical trials, since the participation in sponsored clinical trials lead to substantial cost savings for the Regional healthcare system, this essay purposes some hypothetical policies to be applied in order to exploit this advantage in economic terms.