Marco Marchetti

Marco Marchetti
Age.Na.S. Agenzia nazionale per i servizi sanitari regionali | Agenas · Health Technology Assessment Unit

MD

About

60
Publications
9,452
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605
Citations
Additional affiliations
January 2017 - present
Istituto Superiore di Sanità
Position
  • Managing Director
August 2015 - December 2016
Unità di Valutazione delle Tecnologie e Innovazione
Position
  • Managing Director
January 2001 - August 2015
Università Cattolica del Sacro Cuore
Position
  • Managing Director

Publications

Publications (60)
Article
PURPOSE The present work aimed at conducting a real-world data analysis on the management costs and survival analysis comparing data from non–small-cell lung cancer (NSCLC) cases diagnosed in the Veneto region before (2015) and after (2017) the implementation of a regional diagnostic and therapeutic pathway including all new diagnostic and therapeu...
Article
Introduction: Coronavirus disease 2019 (COVID-19) is caused by a severe acute respiratory syndrome coronavirus 2, which is a human coronavirus responsible for a pandemic. Direct interventions, i.e. physical distancing and use of protective devices, can prevent or limit contagions, however, it is also required to evaluate the optimization of limited...
Article
Full-text available
Background Non‐small cell lung cancer (NSCLC) is the first cause of cancer‐related death among men and the second among women worldwide. It also poses an economic threat to the sustainability of healthcare services. This study estimated the direct costs of care for patients with NSCLC by stage at diagnosis, and management phase of pathway recommend...
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Decision makers are used to consider Out-of-Pocket Expenditure (OOPE) within a health technology assessment framework in order to account for an indicator relying on the level of fairness and on the quality of care of a health system. In this paper, we provide estimates on the determinants of OOPE in Italy by using data coming from an observational...
Article
Full-text available
Aim: In this article, we aim to present a tool for the early assessment of medical technologies. This evaluation system was designed and implemented by the National Centre for HTA and the National Centre for Innovative Technologies of the Istituto Superiore di Sanita, Italy, in order to respond to an institutional commitment within the “Health Tech...
Article
Background Non-small-cell lung cancer (NSCLC) is the first cause of cancer-related death among men and the second among women worldwide. It also poses an economic threat to the sustainability of healthcare services. This study estimates the direct costs of care for patients with NSCLC by stage at diagnosis and management phase of pathway recommende...
Article
Introduction Understanding of the role of contextual factors in determining the real value of health technologies is one of the major challenges for the use of Health Technology Assessment (HTA) methodology within hospitals. Moreover, the responsibility of assessing hospital performance is problematic. Although a number of managerial tools are avai...
Article
The disinvestment of ineffective or inappropriate technologies or interventions with an inadequate value for money ratio is a growing priority in order to contribute to the objectives of maintaining high quality and appropriate care and allocation of resources that guarantee the sustainability of the National Health System (NHS).The possibility of...
Article
Issue/problem Modern patient care requires a heavy investment in innovative health technologies while at the same time it is facing a fiscal sustainability challenge in the health care system. Evidence on effectiveness of health technologies informing Health Technology Assessments (HTA) have traditionally been based on randomized control trials (RC...
Article
Issue/problem National healthcare systems worldwide are at a critical point due to the fiscal sustainability challenges faced. At the same time, healthcare systems are under pressure to meet the global demand for adaptation of medical innovations arriving into the market persistently. Description of the problem Hospitals often serve as the entry p...
Article
Purpose: To assess risk factors for 28-day mortality and cost implications in intensive care unit (ICU) patients with complicated intra-abdominal infections (cIAIs). Methods: Single-center retrospective cohort study of prospectively collected data analysing ICU patients with a microbiologically confirmed complicated intra-abdominal infections....
Article
Objectives The emergence of new medical technologies and budget restrictions has led to a substantial increase in the use of hospital-based health technology assessment (HB-HTA). This qualitative study explores whether there is a possibility and interest to realize the collection and dissemination of HB-HTA reports on an international scale by expl...
Article
In the first article in this series we described the GRADE (Grading of Recommendations Assessment, Development and Evaluation) Evidence to Decision (EtD) frameworks and their rationale for different types of decisions. In this second article, we describe the use of EtD frameworks for clinical recommendations and how it can help clinicians and patie...
Article
Objectives: Hospital-based health technology assessment (HB-HTA) is becoming increasingly relevant because of its role in managing the introduction and withdrawal of health technologies. The organizational arrangement in which HB-HTA activities are conducted depends on several contextual factors, although the dominant models have several similariti...
Article
Introduction Acute myocardial infarction (AMI) is one of the leading causes of death and disability worldwide. The European Society of Cardiology Guidelines have established a new definition of myocardial infarction and have strengthened the central role of cardiac troponins in cardiology diagnostics for rule-in and rule-out of non ST-elevation myo...
Article
Introduction In Italy, the central government sets the health benefit package (denominated “Livelli Essenziali di Assistenza” - LEAs) of the National Health System (NHS), which must be provided to all residents. In 2004, the Italian Ministry of Health established a new technical body, the National LEA Commission, responsible for updating LEAs. Met...
Article
Full-text available
Introduction: Treatment options for macular edema include intravitreal corticosteroids. Traditionally, an injectable suspension of triamcinolone acetonide (TA) had been employed off-label; in recent years, authorities have approved sustained-release drug delivery systems (DDSs) for corticosteroids. This review aims to compare the quality of the evi...
Article
INTRODUCTION Treatment options for macular edema include intravitreal corticosteroids (1). Traditionally, an injectable suspension of triamcinolone acetonide (TA) had been employed off-label (2); in recent years, authorities have approved sustained-release drug delivery systems (DDSs) for corticosteroids (3). Considering the hypothesis that the use...
Article
Objectives: Health technology assessment (HTA) yields information that can be ideally used to address deficiencies in health systems and to create a wider understanding of the impact of different policy considerations around technology reimbursement and use. The structure of HTA programs varies across different jurisdictions according to decision-m...
Article
Full-text available
Although existing clinical evidence shows that the transfusion of blood components is becoming increasingly safe, the risk of transmission of known and unknown pathogens, new pathogens or re-emerging pathogens still persists. Pathogen reduction technologies may offer a new approach to increase blood safety. The study is the output of collaboration...
Article
Full-text available
Objectives: Health technology assessment (HTA) carried out for policy decision making has well-established principles unlike hospital-based HTA (HB-HTA), which differs from the former in the context characteristics and ways of operation. This study proposes principles for good practices in HB-HTA units. Methods: A framework for good practice crite...
Article
Introduction: The aim of this study was to identify, quantify and evaluate the use of robotic materials and operating theatre times in Telelap ALF-X robotic hysterectomy. Materials and methods: Cost analysis was performed on 81 patients who underwent a Telelap ALF-X robotic hysterectomy. Data were collected during a phase II study trial conducte...
Chapter
Health Technology Assessment and Innovation Unit support informed decision-making in the selection of new technologies and disinvestment of obsolete technologies at the hospital level. Future evolution on HTA and Innovation Unit is related to increasing activities in assessing technologies at early stage of development in order to support, in colla...
Chapter
The use of health technology assessment (HTA) as part of the decision-making process at national, regional, and international levels has evolved considerably over the past 40 years.
Research
Full-text available
Available from: http://www.adhophta.eu/adhophta-toolkit Guidance and tools facilitating pragmatic application of guiding principles for good practices in HB-HTA units. This toolkit is based on the HANDBOOK for HB-HTA developed by the AdHopHTA project. This toolkit is one of the final results of the research project AdHopHTA (Adopting hospital-base...
Article
Full-text available
This study assesses the cost-effectiveness of eltrombopag in the treatment of hepatitis C virus (HCV)-related thrombocytopenia. A Markov model was constructed on the basis of the clinical trials ENABLE 1 and ENABLE 2. Three alternatives were considered: scenario 1; treatment with eltrombopag in both the enabling phase and during antiviral therapy,...
Article
Full-text available
The aim of this paper is to identify the stakeholders involved in the Health Technology Assessment (HTA) process with particular attention to their role and potential contribution from patients and citizens. Moreover, a focus on elements to be shared among stakeholders will be provided. These topics were discussed at the Health Policy Forum, an ini...
Article
Objective The aim of this study was to assess whether S-1 might represent a valuable therapeutic option for patients with advanced gastric cancer in comparison to other available therapies (5-FU, capecitabine), considering both costs and outcomes associated with the different therapeutic strategies. The perspective of the analysis was that of the I...
Article
The reduction of nosocomial infections represents a major challenge for large hospitals in order to pursue efficiency. Despite in Europe 7.7% of admitted patients are infected during their hospital stay — in Italy this rate is thought to be close to 6.8% —, the need to reduce the economic impact of nosocomial infections is still considered a major...
Article
Objective To evaluate the cost-effectiveness of onabotulinumtoxinA versus placebo in patients with chronic migraine from the Italian National Health Service and a societal perspective. Design The economic analysis is based on a Markov model developed to evaluate costs and effects for a cohort of patients treated with onabotulinumtoxinA or placebo...
Article
Objective: To evaluate the cost-effectiveness of onabotulinumtoxinA versus placebo in patients with chronic migraine from the Italian National Health Service and a societal perspective. Design: The economic analysis is based on a Markov model developed to evaluate costs and effects for a cohort of patients treated with onabotulinumtoxinA or placebo...
Article
Background: Total thyroidectomy (TT) can be performed either with the traditional technique or using the ultrasound scalpel. Here, the use of the ultrasound scalpel is investigated in order to assess cost-effectiveness from an hospital, third party payer and societal perspective. Methods: A randomized controlled trial was conducted at the Univer...
Article
Background Total open thyroidectomy can be performed either with the conventional knot tying technique (nHS) or using the ultrasonically activated shears (harmonic scalpel, HS). The HS, developed in the ‘90s, initially used for laparoscopic surgery, is an innovative method for haemostasis that has been tested in thyroid surgery. Here, the use of th...
Article
Full-text available
Escherichia coli is the leading cause of bloodstream infections (BSIs) caused by Gram-negative bacteria. The increasing prevalence of antibiotic-resistant E. coli strains, particularly those producing extended-spectrum β-lactamases (ESBLs), increases the odds that empirically prescribed antimicrobial therapy for these infections will be inadequate,...
Article
The reduction of nosocomial infections represents a major challenge for large hospitals in order to pursue efficiency. Despite in Europe 7.7% of admitted patients are infected during their hospital stay - in Italy this rate is thought to be close to 6.8% -, the need to reduce the economic impact of nosocomial infections is still considered a major...
Article
Background: Total open thyroidectomy can be performed either with the conventional knot tying technique (nHS) or using the ultrasonically activated shears (harmonic scalpel, HS). The HS, developed in the '90s, initially used for laparoscopic surgery, is an innovative method for haemostasis that has been tested in thyroid surgery. Here, the use of t...
Article
Technology overlapping is a phenomenon based on the availability of different technologies to treat the same morbidity in the same patient group. The aim of this study was to explore the cost-effectiveness of technology overlapping in a case study on colorectal cancer (CRC), and describe an approach to investigate the phenomena and to propose adequ...
Article
Full-text available
The aim of this study was to analyze and describe process and outcomes of two pilot assessments based on the HTA Core Model, discuss the applicability of the model, and explore areas of development. Data were gathered from HTA Core Model and pilot Core HTA documents, their validation feedback, questionnaires to investigators, meeting minutes, email...
Article
Full-text available
The aim of this study was to review the history of health technology assessment (HTA) in Italy. Founded in 1978, the Italian National Health Service (NHS) has been strongly regionalized mainly after a constitutional reform, which started a devolution process. HTA started in the 1980s at the National Institute of Health and in a few University Hospi...
Article
We evaluated the safety and cost-effectiveness of the harmonic scalpel (HS) during conventional "open" thyroidectomy (CT). Two hundred patients scheduled for conventional total thyroidectomy (TT) were included in the study and randomly assigned to TT with the use of HS (HS group) or with knot tying technique (KT group). Mean operative time was sign...
Article
In a context of continuous spread health technologies, in which particular intensive procedures are performed, the use of procedure volume indicators supports the decision making process in monitoring and improving the healthcare quality. The aim of our work focuses on the evaluation of the association between the volume of procedures performed by...
Article
Our main purpose was to evaluate the organizational appropriateness of admissions made in a university hospital, by comparing two iso-gravity classification systems, APR-DRG and Disease Staging, with the Italian version of AEP (PRUO). Our analysis focused on admissions made in 2001, related to specific Diagnosis Related Groups (DRGs), which, accord...
Article
Full-text available
p> Introduction The risk management project of The University Hospital “A. Gemelli” aims to define the necessary procedures to manage clinical risk, by identifying the structures involved within this process, so that all of the personnel can contribute to a measurable improvement in the safety of both patients and staff. Methods The Risk Manageme...
Article
Full-text available
Background: Healthcare professionals play a key role in tobacco use prevention because they are considered as model by patients. This multicenter study was aimed to evaluate smoking prevalence, knowledge and attitudes towards tobacco among Italian hospital professionals. Methods: A cross-sectional study was carried out using a questionnaire adminis...
Article
p>The Italian National Health Care Service, as many other industrialised countries’, has to cope with increasing health care needs in spite of the limited resources available. Therefore, it is necessary to assess diagnostic-therapeutic procedures, technologies and organizational standards, in order to allocate the available resources appropriately...
Article
Full-text available
p>The Italian National Health Care Service, as many other industrialised countries’, has to cope with increasing health care needs in spite of limited resources available. Therefore, it is necessary to assess diagnostic-therapeutic procedures, technologies and organizational standards, in order to allocate the available resources appropriately. H...
Article
Full-text available
Despite a clear call for greater input from health technology assessment (HTA) in the areas of clinical practice and policy making, there are currently very few formal training programs. The objectives of our Consortium were to (i) develop a master's level program in HTA, (ii) test its content with a group of Canadian and European students, and (ii...
Article
Julkaisussa: HTA core model for diagnostic technologies, v 1.0r. Copenhagen: EUnetHTA. December 2008: 101–130. http://www.eunethta.net/upload/WP4/Final%20Deliverables/HTA%20Core%20Model%20for%20Diagnostic%20Technologies%201%200r.pdf
Article
The quality and dimensions of the Quality Handbook in healthcare are shortly defined. Particular emphasis is put on the role of the quality of compliance and on certification (ISO 9000). The role of quality assessment in healthcare processes is described. It is not conceived as an inspection but rather as an incentive to a continuous quality improv...
Article
The Quality Handbook includes the description of the activities carried out in Radiotherapy and the methodology used to ensure the Quality Assurance according to the principles indicated in national and international documents of reference and the recommendations of accreditation agencies. The structure of the Quality Handbook, the main aspects of...
Article
The approach to the implementation of a Quality Assurance Program applied from 1 October 2000 at the Radiotherapy Service of the "Università Cattolica del S. Cuore, Policlinico "A. Gemelli" of Rome, is described. Some major aspects of this program are analyzed.
Article
Brachytherapy is a conventional method of radiation therapy characterized by peculiar technical, clinical, operational and radioprotection problems. Therefore, the management of a service or department of brachytherapy requires a specific organization aimed at Quality Assurance. In this report, the personal experience with the drawing up of a Quali...
Article
Monitoring and outcomes of experimental solutions adopted in management process reengineering of a teaching hospital ("Policlinico A. Gemelli") of approximately 1550 beds are reported. All monitored processes are considered. For each process, information flows are analyzed, specifying indicators used for monitoring of adopted organizational solutio...
Article
Viral hepatitis B is a highly prevalent disease in the population, and represents an occupational risk for health care workers, frequently exposed to blood or other biological fluids. Vaccination with recombinant vaccines has allowed for widespread vaccination campaigns, particulary targetted to health care workers who are at risk. Nevertheless, th...

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