[Statin therapy: cost-effectiveness and evaluation of evidence as criterium for improving expenditure within the National Health Program]. / Terapia medica con le statine: valutazione costo/efficacia e della migliore evidenza clinica per razionalizzare la spesa del Servizio Sanitario Nazionale.

The choice is difficult in medicine. But individual physicians and patients must make medical decisions rather than organizations or pharmaceutical companies. The choice concerns the transparency of the decision-making process (evidence based medicine), and mistrust of the methods used in cost-effectiveness analysis. Medicare's policy of paying for any medical advance that has positive benefits, regardless of its costs, is un-sustainable. Cost-effectiveness information may assume a more important role in future coverage decisions with regard to outpatient prescription drugs, but at the private level, rather than at the national one. Functional equivalence of drugs reflects a reference-pricing technique applied to a therapeutic category--reimbursement for compounds of similar efficacy within a therapeutic class set to the lowest-priced product in the class. Essentially, a standard of functional equivalence applies a cost-effectiveness principle: assuming that alternative interventions are equivalent, one should not pay more for one of them.

[Prevalence of the metabolic syndrome among Italian adults. Findings from the SIMAP study]. / Prevalenza della sindrome metabolica in una zona territoriale della Regione Marche.

The third report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III) highlights the importance of treating patients with the metabolic syndrome to prevent cardiovascular disease. Limited information is available about the prevalence of the metabolic syndrome in Italy. To estimate the prevalence of the metabolic syndrome in Italy as defined by the ATP III report, 367 men and 491 women aged 20 years or older were studied. Prevalence of the metabolic syndrome as defined by ATP III (3 of the following abnormalities: waist circumference greater than 102 cm in men and 88 cm in women; serum triglycerides level of at least 150 mg/dL; high-density lipoprotein cholesterol level of less than 40 mg/dL in men and 50 mg/dL in women; blood pressure of at least 130/85 mm Hg; or serum glucose level of at least 110 mg/dL) were 22.3% in men and 27.2% in women, respectively. These results show that the metabolic syndrome is highly prevalent.