{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T13:52:05Z","timestamp":1791899525088,"version":"4.3.4"},"reference-count":22,"publisher":"Aboutscience Srl","issue":"1","license":[{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Grhta"],"abstract":"<jats:p>Introduction: Severe asthma imposes a substantial clinical, social, and economic burden, particularly within healthcare systems facing increasing pressure to ensure access to innovations such as biologics. Traditional economic evaluations, focused on single strategies, are often insufficient to capture the broader impact of integrated policy interventions. This study assesses the clinical, economic, social, and fiscal impact of three policy strategies for severe asthma management in Italy: (i) improved treatment adherence, (ii) expanded access to biologics, and (iii) earlier disease identification through structured healthcare approaches, using a multidimensional predictive modeling framework.Methods: A combined methodological approach was adopted, integrating a Budget Impact Analysis, a cost-of-illness model, and a Markov model over a five-year horizon. The model was developed from the perspectives of the National Health Service, society, and the fiscal system. Clinical and economic inputs were derived from national tariffs, AIFA transparency lists, and the scientific literature.Results: The baseline scenario shows increasing costs over five years, mainly driven by exacerbation management and productivity losses. Policy 1 and Policy 3 generate cost reductions compared with the baseline scenario, whereas Policy 2 increases expenditures due to higher biologic uptake. The integrated scenario yields an overall benefit, with a cumulative reduction of \u20ac 3.5 billion and improvements across all perspectives.Conclusions: Integrated care pathways combining early diagnosis, improved adherence, multidisciplinary management, and appropriate biologic use represent the most effective strategy to improve outcomes while maintaining sustainability. These findings highlight the need for systemic policies supporting equitable access to innovation.<\/jats:p>","DOI":"10.33393\/grhta.2026.3785","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T13:20:13Z","timestamp":1791897613000},"page":"249-259","source":"Crossref","is-referenced-by-count":0,"title":["Clinical and economic evaluation of integrated strategies for severe asthma management in Italy: a multidimensional predictive approach"],"prefix":"10.33393","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0094-0302","authenticated-orcid":false,"given":"Filippo","family":"Rumi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9294-1241","authenticated-orcid":false,"given":"Debora","family":"Antonini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3042-0765","authenticated-orcid":false,"given":"Matteo","family":"Bonini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8467-2557","authenticated-orcid":false,"given":"Giorgio Walter","family":"Canonica","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"18642","published-online":{"date-parts":[[2026,10,12]]},"reference":[{"key":"21258","doi-asserted-by":"crossref","unstructured":"Braido F, Blasi F, Canonica GW, et al; MANI Network. Mild\/Moderate Asthma Network in Italy (MANI): a long-term observational study. J Asthma. 2022;59(9):1908-1913. https:\/\/doi.org\/10.1080\/02770903.2021.1968895 PMID:34469268","DOI":"10.1080\/02770903.2021.1968895"},{"key":"21259","doi-asserted-by":"crossref","unstructured":"Scortichini M, Mennini FS, Marcellusi A, Paoletti M, Tomino C, Sciattella P. The economic burden of asthma in Italy: evaluating the potential impact of different treatments in adult patients with severe eosinophilic asthma. Eur J Health Econ. 2025;26(5):869-876. https:\/\/doi.org\/10.1007\/s10198-024-01736-5 PMID:39690320","DOI":"10.1007\/s10198-024-01736-5"},{"key":"21260","doi-asserted-by":"crossref","unstructured":"Heffler E, Blasi F, Latorre M, et al; SANI Network. The Severe Asthma Network in Italy: findings and Perspectives. 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Burden of severe asthma in Italy: patients treated with versus eligible for monoclonal antibodies in a large real-world study. J Int Med Res. 2026;54(1):3000605251409996. https:\/\/doi.org\/10.1177\/03000605251409996 PMID:41529921","DOI":"10.1177\/03000605251409996"},{"key":"21271","doi-asserted-by":"crossref","unstructured":"Engelkes M, Janssens HM, de Jongste JC, Sturkenboom MC, Verhamme KM. Medication adherence and the risk of severe asthma exacerbations: a systematic review. Eur Respir J. 2015;45(2):396-407. https:\/\/doi.org\/10.1183\/09031936.00075614 PMID:25323234","DOI":"10.1183\/09031936.00075614"},{"key":"21272","unstructured":"Mennini FS, Scortichini M, Marcellusi A, Paoletti M, Tomino C, Sciattella P. Impatto economico dell\u2019asma severo in Italia: una valutazione delle potenziali riduzioni di spesa nei pazienti adulti con asma severo eosinofilico. CEIS Economic Evaluation and HTA (EEHTA), Universit\u00e0 degli Studi di Roma \u201cTor Vergata\u201d; 2023. 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