The availability of a new 20-valent pneumococcal conjugate vaccine (PCV) makes it appropriate to assess its cost-effectiveness. This was evaluated by adopting the Italian National Health Service perspective, using a cost consequences Markovian model. The expected effects of vaccination with 20-valent PCV were compared with the administration of 13-valent PCV and 15-valent PCV. Assuming a 100% vaccination of cohorts aged 65–74 years, in the (lifetime) comparison between 20-valent PCV and 13-valent PCV, the former is dominant (lower cost for a better health outcome). A reduction in disease events was estimated: −1208 deaths; −1171 cases of bacteraemia; −227 of meningitis; −9845 hospitalised all-cause nonbacteremic pneumonia cases (NBP) and −21,058 non-hospitalised. Overall, in the Italian population, a total gain of 6581.6 life years and of 4734.0 QALY was estimated. On the cost side, against an increase in vaccinations costs (EUR +40.568 million), other direct health costs are reduced by EUR 48.032 million, with a net saving of EUR +7.464 million. The comparison between 20-valent PCV and 15-valent PCV results in an Incremental Cost-Effectiveness Ratio (ICER) of EUR 66 per life year gained and EUR 91 per QALY gained. The sensitivity analyses confirm the robustness of the results. We can conclude that the switch to 20-valent PCV is a sustainable and efficient investment.

Background: Chronic ischemic cardiovascular disease (CICD) is a common cardiovascular disease and a frequent cause of hospitalization, with significant differences between men and women. It is also an important comorbidity, affecting hospitalization length and mortality. The purpose of this paper is to investigate the clinical and economic impact of CICD on hospital admissions of non-surgical patients. Methods: To conduct the study, hospital discharge data (SDO) from each public and private hospital facility regularly sent by the regions to the Ministry of Health were analyzed, focusing on internal medicine, cardiology, and geriatrics departments’ 2019 discharged data coming from all Italian hospitals. Data were stratified according to age, gender, hospital charge ward, and costs. Results: The typical CICD patient is elderly (average age 80 years) and stays longer (+10.5 days) compared to the average one. They are also typically chronic patients with many comorbidities (respiratory and renal failure, as well as atrial fibrillation) in geriatrics and internal medicine departments, while in the cardiology departments, atrial fibrillation and outcomes of acute cardiovascular events predominate. Conclusions: CICD is a condition that leads to more hospitalizations in internal medicine departments than in cardiology and geriatrics departments and generates an average hospitalization value in line with the average one in internal medicine and geriatrics departments. In cardiology, the average value level is higher than the department average. Gender differences were found in cardiology departments; this data could suggest that the existing guidelines are affected by studies carried out mainly on males which lead to fewer recommendations for interventional procedures on females.

Background/Objectives: Chronic ischemic cardiovascular disease (CICD) a common cardiovascular diseases and a frequent cause of hospitalization, with significant differences between men and women. It is also an important comorbidity, affecting hospitalization length and mortality. The purpose of this paper is to investigate clinical and economic impact of chronic ischemic cardiovascular disease on hospital admissions of non-surgical patients. Methods: all Internal Medicine, Cardiology, and Geriatrics admissions in Italy during year 2023 have been considered. to assess the impact of typical comorbidities in elderly patients and to better understand how users diversify across the three specialties and whether the differences are significant between males and females. Results: The typical CICD patient is elderly (average age 80y) and stays longer (+10.5 days) compared to the average one. They are also typically chronic patients with many comorbidities (respiratory and renal failure, as well as atrial fibrillation) in Geriatrics and Internal Medicine Departments, while in the Cardiology Departments atrial fibrillation and outcomes of acute cardiovascular events predominate. Conclusions: CICD is a condition that leads to more hospitalizations in Internal Medicine Departments than in Cardiology and Geriatrics Departments and generates an average hospitalization value in line with the average one in Internal Medicine and Geriatrics Departments. In Cardiology the average value level is higher also than the Department average. Gender differences were found in In Cardiology Departments; this data could suggest that the existing Guidelines are affected by studies carried out mainly on males which lead to fewer recommendations for interventional procedures on females.