Economic evaluation of distribution modalities for ostomy and incontinence medical devices within the italian healthcare context

Introduction: The clinical management of ostomy and urinary incontinence poses a substantial challenge forhealthcare systems and patients, as it necessitates the provision of specialized medical devices. In Italy, thesedevices are distributed through multiple distribution modalities.Methods: This study aims to update a previous Budget Impact analysis on home distribution, using real-worlddata collected via surveys and applying an ABC approach. Structured questionnaires were administered to theASL of four Italian regions, collecting data on staff involvement, operational times, and resource utilization. TheBIM analysis compared two scenarios: the current distribution scenario and a hypothetical scenario with incremental adoption of home delivery.Results: The estimated average annual personnel costs per patient were € 153 for direct distribution, € 107 forhome delivery, and € 80 for indirect distribution. The revised scenario resulted in an increased resource consumption of € 214,475,929 over three years. This increase was offset by significant cost reductions in direct(-€ 165,195,792) and indirect distribution (-€ 52,704,435), yielding a cumulative saving of € 3,424,299 over theanalysis period. Sensitivity analysis confirmed the robustness of the results with respect to the main parameters.Conclusion: The integration of real-world data significantly improves the accuracy and robustness of the BIManalysis. The results support home distribution as a cost-efficient choice for the Italian National Health Service(SSN). The evidence generated provides valuable insights for policymakers to optimize resource allocation anddistribution strategies for stoma and urinary incontinence devices.