Un modello di Activity- Based Costing applicato al processo di gestione dei pazienti con emicrania presso l’IRCCS Fondazione Mondino

An Activity-Based Costing model applied to the management process of patients with migraine at IRCCS
Mondino Foundation
Background and aim: The ageing of the general population, with the increase in chronic diseases, poses the
need for using technological innovation to face the growing healthcare needs. The present analysis applied the
Activity-Based Costing tool in migraine patients followed at the IRCCS Mondino of Pavia to formalize and quantify
the costs of the whole patient’s management process and to estimate the overall economic burden of migraine
from the perspective of the National Health Service (NHS).
Methods: A two-stage analysis was conducted. The first stage aimed at drawing patient’s pathway, defining all
the possible activities and actors involved in the healthcare delivery and treatment for migraine at the IRCCS during
year 2022. The second phase was the development of a model to estimate the costs of the entire process by
pricing the individual activities.
Results: The described model yielded an estimated total annual cost for the overall management of migraine of
€ 1,222,392, corresponding to a direct cost for a therapy of approximately 6 months per single patient of € 814.
The most impactive items on the estimated annual expenditures were hospitalizations, followed by diagnostic
examinations after follow-up visits and drugs dispensed by Hospital Pharmacy for home-administration (monoclonal
antibodies).
Conclusions: This analysis allowed detailing the single activities and resources used in migraine patient’s pathway
and then estimating the direct costs sustained by the NHS. The model could be translated to other diseases for
optimizing the diagnostic/therapeutic and economic management of assisted patients and improving healthcare
resource allocation.
Keywords: Activity-based costing, Healthcare costs, Migraine, Migraine therapy