Observatory on the impact of the
COVID-19 pandemic on the accessto healthcare
Data period: 2019-2020
March 2021

Study performed by IQVIA with Farmindustria’s non conditioning
support© 2021. All rights reserved. IQVIA® is a registered trademark of IQVIA Inc. in the United States, the European Union, and various other countries.

Premise and objectives of the study
The pandemic had important effects both on the initiation of and access to treatments, with significant
consequences on clinical outcomes
The sanitary emergency that hit the country is having a significative impact on the healthcare system. The complexity of the pandemic and the issues related to the
management of infected people challenged the healthcare system causing the saturation of both hospitals and intensive care units. Therefore, it created the need for
new procedures and paths dedicated to both severe Covid-19 patients treated in hospital and less-severe patients in home care. Moreover, the pandemic produced adecrease in the access to treatments in all the areas, from oncology to respiratory and cardio-metabolic chronic diseases.
Along with the concerns related to the management of infected patients, the extended lockdown periods had important effects also on the access to visits andtreatments of non-Covid patients producing significant consequences for patients’ health and the organization of the healthcare system (hospital-territory integration,
remote patient management).
The analysis of the IQVIA data allows to deepen the knowledge of the following topics:• What are the main chronic diseases affected by Covid-19?
• What has been the reduction in new diagnoses and new treatments over the months?
• What has been the impact on requests for specialist visits and requests for exams?
• Was there a difference between the impact of the first and second wave of Covid-19?
In this context, IQVIA realized a study aimed at monitoring the impact of the pandemic on access to diagnoses and treatments and its evolution in the months tocome. The study was realized by an ad-hoc observatory and with the non conditioning contribution of Farmindustria, and it will be updated every three months. The
analysis is based on Real World Data evidences gathered from a sample of 900 general practitioners and a panel of 450 onco-hematologists representative of thereference universes.
In this document data refer to the 12 months from January to December 2020 which are compared to the same period of 2019. The study will continue for the entire
2021 with quarterly updates.
When it comes for primary care area, the results of this study highlight the indirect impact of Covid on territorial medicine, which is a fair proxy of the impact on
outpatient activity volumes.

© IQVIA 2021. All rights reserved.

2

Main findings
The contraction of the entire
pharmaceutical sector recorded
in 2020 (-3,6% MAT 12/2020)
unveils the limitations to accessto treatments both in thehospitals and in the pharmacies
In 2020, access to diagnoses andtreatments in the maintherapeutic areas witnessed asignificant contraction compared
to 2019DATA SOURCESIQVIA LPD (Longitudinal Patient Database)- Records collected from patient management
software – Panel of 900 GPs
Oncology Dynamics: collection of patients
data forms - Panel of 450 onco-hematologists• In 2020, the main respiratory and cardio-metabolic pathologies witnessed a significant contraction of the
new diagnoses (-613.000 equal to a reduction of 13%), treatment initiations (-350.000, -10%), specialist visits(-2,2M, -31%) and requests for exams (-2,9M, -23%).
• In the respiratory area (COPD/asthma) there was a significant drop in new diagnoses (COPD: -84.000;
Asthma: -195.000), new treatments (-65.000, -159.000), referral to specialists (-154.000, -158.000) andspirometry requests (-136.000, -157.000). The two waves of Covid-19 had a similar impact and 2020 dataremains far from 2019, even there was a minor impact during the summer months.
In the cardiovascular area (atrial fibrillation/heart failure/hypertension) data show a huge contraction in new
diagnoses (AF -47.000, HF -19.000, hypertension -211.000), new treatments (-29.000, -3.000, -69.000),
referrals to cardiologist (-301.000, -99.000, -1,1M) and requests for ECG (-214.000, -78.000, -1,3M). The two
Covid-19 waves had the greatest impact on referrals to the cardiologist and requests for ECGs, generating astrong annual reduction, while there has been a partial recovery in the second half of the year of new
diagnoses and new treatments.
Diabetes area also recorded a drop in the number of new diagnoses (-58.000), new treatments (-24.000),
referrals to diabetologists (-400.000) and request for exams (-1,1M). The two Covid-19 waves impacted
mostly referrals to the diabetologist and blood glucose tests, while there was a partial recovery in the second
half of the year on new diagnoses and new treatments.
• Oncology area also experienced a contraction in the access to diagnoses and treatments. The partial
recovery achieved during the summer did not compensate the drop caused by the two Covid-19 waves:
overall in 2020 there were 30.000 cancer diagnoses less than the ones made in 2019. In 2020 we observeda relevant reduction of screening requests for breast cancer (-9%), lung cancer (-9%) and colon cancer(-14%). In addition, new diagnoses for cancer dropped (-11%), as well as treatment initiations (-13%),surgeries (-18%) and hospitalizations (-16%). After the initial halt to screening and follow up visits due to theclosure of many departments and ambulatories at the beginning of the year, there was partial recovery during
the summer, which id not offset the contraction of diagnoses and treatments. The new contraction caused by
the second pandemic wave contributed to increase the annual contraction with respect to 2019.

IQVIA National Integrated Database
December 2020
© IQVIA 2021. All rights reserved.

3

The contraction witnessed by the pharmaceutical sector (-3,6%) shows thelimitation of access to treatments both in hospitals and pharmacies
Evolution of the pharmaceutical sector

Total(Sell-in Billion €)

23,0

12,6

10,4

22,2

12,1

Variation of thepharmaceutical by channel

Values(Sell-in Billion €)Total- 3,6%

Hospital and directpurchases- 3,9%

Pharmacy- 3,1%

10,0
Hospital and direct purchases
Pharmacy

MAT 12/2019

MAT 12/2020

Values are expressed considering the weighted average price for the hospital channel and direct purchases (included the DPC channel), ex-factory for pharmacy channel - Class A, A with note, Class C and Class H are taken into accountSource: IQVIA National Integrated Database December 2020
© IQVIA 2021. All rights reserved.

4

PRIMARY CARE AREA

In 2020, Covid-19 had a relevant impact on the number of new diagnoses andtreatments, in addition to the requests of specialist visits and exams
Real World Data from GPs – FOCUS: COPD, ASTHMA, ATRIAL FIBRILLATION, HEART FAILURE, HYPERTENSION, DIABETES-613.000-350.000 -2.230.000 -2.860.000[-13%][-10%][-31%][-23%]NEW
DIAGNOSESNEW
TREATMENTS

REFERRALS TO
SPECIALISTSREQUEST FORTESTS/EXAMSJanuary-December 2020 vs 2019 annual variation© IQVIA 2021. All rights reserved.

5

PRIMARY CARE AREA

In 2020, chronic respiratory and cardio-metabolic pathologies witnessed an important
contraction of exams requests, referrals to specialists, new diagnoses and treatments;
respiratory area is the most affected, while diabetes was less impacted
Analysis of activities January-December 19/20 (YoY – % values)-50% -45% -40% -35% -30% -25% -20% -15% -10% -5%

Total deviation

-25%
-19%
-13%
-10%

New diagnoses

-23%
-18%
-2%
-4%
-5%

New treatments-350.000• Overall, number of new treatments decreased by -10% in 2020 with respect to
2019• COPD and Asthma remain the most impacted areas (-23% e -18%), followed by
AF (-11%) and diabetes (-5%), while hypertension (-4%) and heart failure (-2%)
were less affected-2.230.000• Referrals to specialists experienced a strong drop in all the therapeutic areas
losing -31% overall• Again, the respiratory area was the most hit with a drop greater than 38%; thecardiological area followed with a una reduction higher than 30%; diabetes
area was the least affected (-22%)(-10%)

-38%
-42%
-33%
-32%
-33%

-613.000• All the therapeutic areas witnessed a reduction in new diagnoses between 925% YTD with respect to 2019 (overall reduction of -13%)• COPD and Asthma are the most affected pathologies with a reduction ofdiagnoses by -25% e -19%, followed by AF (-13%), HF and hypertension (-10%)
and diabetes (-9%), in which the impact of pandemic was better managed(-13%)

-10%
-9%

-11%

Referral to specialist(-31%)

-22%
-46%
-45%
-29%
-28%

Notes

0%

Exams requests

-31%
-15%

-2.860.000(-23%)• Requests for specialist exams suffered an overall impact of -23% compared tothe previous year
• Even in this case, the respiratory diseases suffered the most (around -46%),
followed by cardiological ones (around -29%); diabetes is the least impacted (15%)
Note: spirometry, glycemia, ECG

COPD

AsthmaAtrial fibrillation

Heart failure

Hypertension

Diabetes

Data source: IQVIA Longitudinal Patient Database (January 2019-December 2020)© IQVIA 2021. All rights reserved.

6

COPD

In the COPD area there were no significant variations in the impact of the two Covid-19
waves, which caused a significant drop of new diagnoses (-25%), new treatments (-23%),
referral to specialists (-38%) and spirometry requests (-46%) with respect to 2019
COPD: comparison January-December 2020 vs 2019
NEW DIAGNOSESNEW TREATMENTS•

Annual variation:-25%; -84.000 pts.

45
Patients (Thousands)

40
35
30

•

25
20
15
10
5
0
Jan

Feb

-31%

-30%

-48.000 pts.

-26.000 pts.

Mar

Apr

May

Jun

Jul

2019

Aug

Sep

Oct

Nov

•

Dec

2020

Between February
and June 2020, newdiagnoses of COPD
decreased by 31% (vs2019)
Between October andDecember 2020,, newdiagnoses of COPD
dropped by 30% (vs
2019)

50

Annual variation:-23%; -65.000 pts.

45

30

35
30

-51%

-48%

20

•

15
10

•

5

-50.000 pts.

-86.000 pts.

0
Jan

Feb

Mar

Apr

May

Jun

2019

Jul

Aug

Sep

2020

Data source: IQVIA Longitudinal Patient Database (January 2019-December 2020)© IQVIA 2021. All rights reserved.

Oct

Nov

Dec

Between October andDecember 2020,
treatment initiations
plunged by 27% (vs
2019)

•

In 2020 new
treatments for COPD
were ~65.000 lessthan 2019

20
15
10

In 2020 COPD new
diagnoses were~84.000 less tan
2019

5

Between February
and June 2020,referrals to
pulmonologist for
COPD fell by 48% (vs
2019)

50

-28%

-27%
-20.000 pts.

-36.000 pts.

0
Jan

Feb

Mar

Apr

May

Jun

Jul

2019

Aug

Sep

Oct

Nov

Dec

2020

Between October andDecember 2020,referrals declined by
51% (vs 2019)
In 2020, requests for
specialist visit for
COPD were ~154.000
less than 2019

• Between February andJune 2020, spirometry
requests for COPD
lowered by 55% (vs2019)

Annual variation:-46%; -136.000 pts.

45
40
Patients (Thousands)

Patients (Thousands)

40

25

•

25

SPIROMETRY REQUESTS•Annual variation:-38%; -154.000 pts.

45

Between February
and June 2020,
treatment initiations
for COPD reduced by
28% (vs 2019)35

REFERRALS TO PULMONOLOGIST
50

•

40
Patients (Thousands)

50

35
30
25
20
15

-55%

-62%

-74.000 pts.

-45.000 pts.

10
5
0
Jan

Feb

Mar

Apr

May

Jun

2019

Jul

Aug
2020

Sep

Oct

Nov

Dec

• Between October andDecember 2020,
spirometry requests
for COPD dropped by
62% (vs 2019)• In 2020, spirometry
requests for COPD
were ~136.000 lessthan 20197

ASTHMA

Covid-19 had a similar effect in both waves even in Asthma area, which witnessed asignificant annual contraction in new diagnoses (-19%), new treatments (-18%), referrals to
specialists (-42%) and spirometry requests (-45%) with respect to 2019
Asthma: comparison January-December 2020 vs 2019
NEW DIAGNOSESAnnual variation:-19%; -195.000 pts.

120
Patients (Thousands)

NEW TREATMENTS• Between February
and June 2020, newdiagnoses of Asthma
decreased by 20%(vs 2019)

100
80
60
40

-20%

-23%

-99.000 pts.

-56.000 pts.

20
0
Jan

Feb

Mar

Apr

May

Jun

2019

Jul

Aug

Sep

Oct

Nov

Dec

2020

• Between October andDecember 2020, newdiagnoses of Asthma
dropped by 23% (vs
2019)

140

100
80
60
40

• In 2020 asthma new
diagnoses for
Asthma were~195.000 less than
2019

20

• Between February andJune 2020, thereferrals to Pulmo for
Asthma fell by 54% (vs
2019)

50

0
Jan

Feb

-16%

-27%

-68.000 pts.

-55.000 pts.

Mar

Apr

May

45
Patients (Thousands)

40
35
30

-54%

25

-53%

20
15
10
5

-50.000 pts.

-89.000 pts.

0
Jan

Feb

Mar

Apr

May

Jun

2019

Jul

Aug

Sep

2020

Data source: IQVIA Longitudinal Patient Database (January 2019-December 2020)© IQVIA 2021. All rights reserved.

Oct

Nov

Dec

Jul

Aug

Sep

Oct

Nov

Dec

2020

• Between October andDecember 2020,
treatment initiations
for Asthma plunged by
27% (vs 2019)• In 2020 new Asthma
treatments were~159.000 less than2019

SPIROMETRY REQUESTS• Between October andDecember 2020, thereferrals to Pulmo
declined by 53% (vs2019)• In 2020, requests for
specialist visits for
Asthma were~158.000 less than2019

• Between February andJune 2020, spirometry
requests for Asthma
lowered by 56% (vs2019)

Annual variation:-45%; -157.000 pts.

45
40
Patients (Thousands)

Annual variation:-42%; -158.000 pts.

Jun

2019

REFERRALS TO PULMONOLOGIST50• Between February andJune 2020, treatment
initiations for Asthma
reduced by 16% (vs2019)

Annual variation:-18%; -159.000 pts.

120
Patients (Thousands)

140

35
30
25
20

-56%

-59%

-87.000 pts.

-53.000 pts.

15
10
5
0
Jan

Feb

Mar

Apr

May

Jun

2019

Jul

Aug

2020

Sep

Oct

Nov

Dec

• Between October andDecember 2020,
spirometry requests
for Asthma decreasedby 59% (vs 2019)• In 2020, spirometry
requests for Asthma
were ~157.000 lessthan 20198

ATRIAL FIBRILLATION

In AF area the two Covid-19 waves had a similar impact on referrals to cardiologists and ECG
requests, increasing the annual contraction (-33% and -29%); new diagnoses and treatments
were better managed during the second wave thus mitigating the annual gap (-13%, -11%)
Atrial fibrillation: comparison January-December 2020 vs 2019
NEW DIAGNOSESNEW TREATMENTS

40
Patients (Thousands)

35
30• Between October andDecember 2020, newdiagnoses of AF
dropped by 7% (vs
2019)

25
20
15
10
5
0
Jan

Feb

-26%

-7%

-42.000 pts.

-6.000 pts.

Mar

Apr

May

Jun

2019

Jul

Aug

Sep

Oct

Nov

Dec

2020

40
35

• In 2020 new
diagnoses of atrial
fibrillation were~47.000 less than
2019

30

• Between October andDecember 2020,
treatment initiations
for AF plunged by 4%(vs 2019)

25
20
15
10

-23%

-4%

-27.000 pts.

-3.000 pts.

5
0
Jan

Feb

Mar

Apr

May

Jun

2019

REFERRALS TO CARDIOLOGIST

-43%

60

-42%

40

• Between October andDecember 2020,referrals to
cardiologist for AF
declined by 42% (vs
2019)

20

-94.000 pts.

-174.000 pts.

0
Jan

Feb

Mar

Apr

May

Jun

2019

Jul

Aug

Sep

2020

Data source: IQVIA Longitudinal Patient Database (January 2019-December 2020)© IQVIA 2021. All rights reserved.

Oct

Nov

Dec

Aug

Sep

Oct

Nov

Dec

2020

• In 2020, requests for
specialist visits for AF
were ~301.000 lessthan 2019• Between February andJune 2020, ECG
requests for AF
lowered by 39% (vs2019)

Annual variation:-29%; -214.000 pts.

100
Patients (Thousands)

Patients (Thousands)

80

Jul

• In 2020 new
treatments for AF
were ~29.000 lessthan 2019

ECG REQUESTS• Between February andJune 2020, referrals to
cardiologist for AF fellby 43% (vs 2019)

Annual variation:-33%; -301.000 pts.

100

• Between February andJune 2020, treatment
initiations for AF
reduced by 23% (vs2019)

Annual variation:-11%; -29.000 pts.

45

Patients (Thousands)• Between February andJune 2020, newdiagnoses of AF
decreased by 26% (vs2019)

Annual variation:-13%; -47.000 pts.

45

80
60
40

-39%

-34%

-127.000 pts.

-62.000 pts.

• Between October andDecember 2020 ECG
requests for AF
decreased by 34% (vs
2019)

20
0
Jan

Feb

Mar

Apr

May

Jun

2019

Jul

Aug

Sep

Oct

Nov

Dec

• In 2020 ECG requests
for AF were ~214.000
less than 20192020
9

HEART FAILURE

Even in heart failure area Covid-19 had a similar effect in both waves, causing an annual
contraction that was more contained for new diagnoses (-10%) and new treatments (-2%) andmore significant for referrals to cardiologists (-32%) and ECG requests (-28%)
Heart failure: comparison January-December 2020 vs 2019
NEW DIAGNOSESAnnual variation:-10%; -19.000 pts.

25
Patients (Thousands)

NEW TREATMENTS• Between February
and June 2020, newdiagnoses of heart
failure decreased by
18% (vs 2019)20• Between October andDecember 2020, newdiagnoses of heart
failure dropped by
12% (vs 2019)

15
10
5
0
Jan

Feb

-18%

-12%

-16.000 pts.

-6.000 pts.

Mar

Apr

May

Jun

2019

Jul

Aug

Sep

Oct

Nov

Dec

2020

30

• In 2020, newdiagnoses of heart
failure were ~19.000
than 201920• Between October andDecember 2020,
treatment initiations
plunged by 6% (vs
2019)

15
10

-6%

-6%

-4.000 pts.

-2.000 pts.

5
0
Jan

Feb

Mar

Apr

May

Jun

2019

REFERRALS TO CARDIOLOGISTPatients (Thousands)

35
30
25
20

-41%

-45%

15
10
5

-33.000 pts.

-56.000 pts.

0
Jan

Feb

Mar

Apr

May

Jun

2019

Jul

Aug

Sep

2020

Data source: IQVIA Longitudinal Patient Database (January 2019-December 2020)© IQVIA 2021. All rights reserved.

Oct

Nov

Dec

Jul

Aug

Sep

Oct

Nov

Dec

2020

• In 2020 new
treatments for HF
were ~3.000 less than2019

ECG REQUESTS• Between February andJune 2020, referrals to
cardiologist for heart
failure fell by 41% (vs2019)

Annual variation:-32%; -99.000 pts.

• Between October andDecember 2020,referrals to
cardiologist for HF
declined by 45% (vs2019)• In 2020, requests for
specialist visits forheart failure were~99.000 than 201940

• Between February
and June 2020, ECG
requests for heart
failure lowered by
37% (vs 2019)

Annual variation:-28%; -78.000 pts.

35
Patients (Thousands).

40• Between February andJune 2020, treatment
initiations for HF
reduced by 6% (vs2019)

Annual variation:-2%; -3.000 pts.

25
Patients (Thousands)

30

30
25
20
15

-37%

-39%

-45.000 pts.

-26.000 pts.

10
5
0
Jan

Feb

Mar

Apr

May

Jun

2019

Jul

Aug

2020

Sep

Oct

Nov

Dec

• Between October andDecember 2020,
ECG requests forheart failure
decreased by 39%(vs 2019)• In 2020 ECG
requests for heart
failure were ~78.000
less than 201910

HYPERTENSIONIn the hypertension area the two waves had a similar effect on referrals to cardiologist and
ECG requests, increasing the annual contraction (-33% and -31%); new diagnoses andtreatments were better managed mitigating the annual gap (-10% and -4%)
Hypertension: comparison January-December 2020 vs 2019
NEW DIAGNOSESNEW TREATMENTS• Between February andJune 2020, newdiagnoses ofhypertension
decreased by 23% (vs2019)

Annual variation:-10%; -211.000 pts.

400
Patients (Thousands)

350
300
250

• Between October andDecember 2020, newdiagnoses dropped by
5% (vs 2019)

200
150
100
50
0
Jan

Feb

-23%

-5%

-213.000 pts.

-28.000 pts.

Mar

Apr

May

Jun

2019

Jul

Aug

Sep

Oct

Nov

Dec

2020

450

350
300

• Between October andDecember 2020,
treatment initiations
incresaed by 2% (vs
2019)

250
200
150
100

• In 2020, newdiagnoses ofhypertension were~211.000 less than
2019

50

• Between February andJune 2020, referrals to
cardiologist for
hypertension fell by
45% (vs 2019)

450

0
Jan

Feb

-14%

+2%

-97.000 pts.

8.000 pts.

Mar

Apr

May

Jun

2019

REFERRALS TO CARDIOLOGISTAnnual variation:-33%; -1,1M pts.

Patients (Thousands)

400
350
300

-45%

250

-43%

200
150
100
50

-351.000 pts.

-675.000 pts.

0
Jan

Feb

Mar

Apr

May

Jun

2019

Jul

Aug

Sep

2020

Data source: IQVIA Longitudinal Patient Database (January 2019-December 2020)© IQVIA 2021. All rights reserved.

Oct

Nov

Dec

Jul

Aug

Sep

Oct

Nov

Dec

2020

• In 2020, newtreatments for
hypertension were~69.000 less than2019

ECG REQUESTS• Between October andDecember 2020,referrals to
cardiologist declinedby 43% (vs 2019)• In 2020, specialist
visit requests were~1,1 million less than2019

• Between February andJune 2020, ECG
requests for
hypertension plunged
by 43% (vs 2019)

Annual variation:-31%; -1,3M pts.

400
350
Patients (Thousands)

450• Between February andJune 2020, treatment
initiations for
hypertension reducedby 14% (vs 2019)

Annual variation:-4%; -69.000 pts.

400
Patients (Thousands)

450

300
250

-43%

-40%

-753.000 pts.

-393.000 pts.

200
150
100
50
0
Jan

Feb

Mar

Apr

May

Jun

2019

Jul

Aug

2020

Sep

Oct

Nov

Dec

• Between October andDecember 2020, ECG
requests for
hypertension loweredby 40% (vs 2019)• In 2020 ECG requests
for hypertension were
~1,3 million less than
201911

DIABETESIn the diabetes area the reduction of diabetologists visits and exams requests has been
similar and caused a greater annual drop (-22% and -15%) of new diagnoses and treatments,
which recovery after the first wave mitigated the annual impact (-9% and -5%)
Diabetes: comparison January-December 2020 vs 2019
NEW DIAGNOSESAnnual variation:-9%; -58.000 pts.

90
Patients (Thousands)

NEW TREATMENTS• Between February
and June 2020, newdiagnoses ofdiabetes decreased
by 26% (vs 2019)

80
70
60

• Between October andDecember 2020, newdiagnoses ofdiabetes decreased
by 1% (vs 2019)

50
40
30
20
10
0
Jan

Feb

-26%

-1%

-78.000 pts.

-2.000 pts.

Mar

Apr

May

Jun

2019

Jul

Aug

Sep

Oct

Nov

Dec

2020

80

Annual variation:-5%; -24.000 pts.

70
Patients (Thousands)

100

60
50
40

20

• Since the beginningof the year, newdiagnoses fordiabetes dropped by~58.000

10• Between February andJune 2020, referrals todiabetologists
decreased by 36% (vs
2019)

900

0
Jan

Feb

-19%

+2%

-37.000 pts.

2.000 pts.

Mar

Apr

200

150

-36%

100

-30%

50

May

Jun

2019

Jul

Aug

Sep

Oct

Nov

Dec

2020

• Between October andDecember 2020,referrals todiabetologists
decreased by 30% (vs2019)

Annual variation:-15%; -1M pts.

800

• Between February andJune 2020, glycemia
tests requests fordiabetes dropped by
26% (vs 2019)

700
600
500
400

-26%

-20%

-748.000 pts.

-314.000 pts.

300
200
100

-133.000 pts.

-280.000 pts.

0
Jan

Feb

Mar

Apr

May

Jun

2019

Jul

Aug

Sep

2020

Data source: IQVIA Longitudinal Patient Database (January 2019-December 2020)© IQVIA 2021. All rights reserved.

Oct

Nov

Dec

• In 2020 ~24.000 new
treatments

GLYCEMIA TESTS REQUESTS

Patients (Thousands)

Patients (Thousands)

Annual variation:-22%; -396.000 pts.

• Between October andDecember 2020,
treatment initiations
increased by 2% (vs
2019)

30

REFERRALS TO DIABETOLOGIST250• Between February andJune 2020, treatment
initiations for diabetes
dropped by 19% (vs2019)• Since the beginning of
the year, specialist visit
requests for diabetes
dropped by ~396.000

0
Jan

Feb

Mar

Apr

May

Jun

2019

Jul

Aug

2020

Sep

Oct

Nov

Dec

• Between October andDecember 2020,
glycemia tests
requests for diabetes
dropped by 20% (vs2019)• In 2020 ~1 million
glycemia tests
12ONCOLOGICAL SCREENING

In the oncological area the impact of the second wave has been lower for mammography andcolonoscopy mitigating the annual reduction (-9% and -14%), but greater for CT scan despite
the increase in December (+70%) that contributed to reduce the annual variation (-9%)
Oncological screening: comparison January-December 2020 vs 2019
BREAST CANCER SCREENING REQUESTS
80%

COLONOSCOPY REQUESTSPULMONARY CT SCAN REQUESTS FOR CANCER

Annual variation:
-9%

80%

60%

60%

40%

40%

Annual variation:
-9%

70%

Annual variation:-14%

0%
Jan Feb Mar Apr May Jun

Jul

Aug Sep Oct Nov Dec

-20%

20%

0%
Jan Feb Mar Apr May Jun

Jul

Aug Sep Oct Nov Dec-20%

Variation 2020 vs 2019 (MoM)

20%

Variation 2020 vs 2019 (MoM)

Variation 2020 vs 2019 (MoM)

50%

30%

10%

-10%

-40%

-50%

-60%

-60%

-70%

-22%

-17%

• Between February and June 2020, the requests of
mammography screening to identify breast cancer decreased
by 22% with respect to the same period in 2019
• The greatest reduction is recorded between march and april 2020(-64%)• Between June and september 2020 it is observed an increaseof 28% vs 2019, that is quite substantial in June (+50%)• Between October and December 2020, there is another drop of
17% vs 2019
Data source: IQVIA Longitudinal Patient Database (January 2019-December 2020)© IQVIA 2021. All rights reserved.

-80%

-7%

-13%

• Between February and June 2020, the requests of CT scan to
identify lung cancer decreased by 7% with respect to thesame period in 2019
• The greatest reduction is recorded between march and april
2020 (-41%)• Between June and september 2020 it is observed an increaseof 10% vs 2019, that is quite substantial in June (+48%)• Between October and December 2020, there is another drop of
13% vs 2019

Jul

Aug Sep Oct Nov Dec

-30%

-40%

-80%

Jan Feb Mar Apr May Jun

-90%

-34%

-13%

• Between February and June 2020, the requests ofcolonoscopy to identify colon cancer decreased by 34% withrespect to the same period in 2019
• The greatest reduction is recorded between march and april
2020 (-66%)• Between June and september 2020 it is observed an increaseof 29% vs 2019, that is quite substantial in June (+47%)• Between October and December 2020, there is another drop of
13% vs 201913

ONCO-HEMATOLOGY

The impact of the second wave has been lower than the first one for new diagnoses andtreatments mitigating the annual reduction (-11% and -13%), but greater for surgeries andhospitalizations causing higher annual drop (-18% and -16%)

Onco-hematology - diagnosis, treatments, hospitalizations, surgeries: comparison January-December 2020 vs 2019
NEW DIAGNOSISAnnual variation:-11%; -30.000 pts.

20%
Variation 2020 vs 2019 (MoM)

TREATMENT INITIATION30%• Between February andJune 2020, newdiagnoses for oncohematology decreased
by 15% (vs 2019)

10%
0%
Jan

Feb

Mar

Apr

May

Jun

Jul

Aug

Sep

Oct

Nov

Dec

-10%

-40%

• Between October andDecember 2020, newdiagnoses decreasedby 14% (vs 2019) due
to second wave of
Covid

-50%

• In 2020 ~30.000

-20%
-30%

-15%

-60%

Annual variation:-13%; -18.000 pts.

20%
Variation 2020 vs 2019 (MoM)

30%

10%
0%
Jan

Feb

-14%

Apr

May

Jun

Jul

Aug

Oct

Nov

Dec

• Between February andJune 2020, surgeries
decreased by 20% (vs
2019)

-10%

• Between October andDecember 2020,
surgeries decreased
by 24% (vs 2019)

-20%
-30%
-40%

• In 2020 ~9.000

-50%
-60%

Sep

Oct

Nov

Dec

-40%

• In 2020 ~18.000

-11%

-18%

Annual variation:-16%; -5.000 pts.

20%

Sep

Aug

HOSPITALIZATIONS FOR TREATMENTS

Variation 2020 vs 2019 (MoM)

Variation 2020 vs 2019 (MoM)

Mar

Jul

-30%

30%

0%
Feb

Jun

• Between October andDecember 2020, theinitiations of newtreatments dropped by
11% (vs 2019)

-60%

10%

Jan

May

-50%

Annual variation:-18%; -9.000 pts.

20%

Apr

-20%

SURGERIES
30%

Mar

-10%

10%
0%
Jan

Feb

Mar

Apr

May

Jun

Jul

Aug

Sep

Oct

Nov

Dec

-10%
-20%

-40%

-24%

Data source: IQVIA Oncology Dynamics Database (january 2019- December 2020) – data expanded to the universe© IQVIA 2021. All rights reserved.

-60%• Between February andJune 2020,
hospitalizations
requests for oncohematologicaltreatments dropped by
16% (vs 2019)• Between October andDecember 2020,
requests dropped by
37% (vs 2019)

-30%

-50%

-20%

• Between February andJune 2020, theinitiations of new
onco-hematologicaltreatments dropped by
18% (vs 2019)• In 2020 ~5.000

-16%

-37%
14

The present report contains updated data with December 2020; the next wave will be
released in June 2021 and it will include updated data with March 2021

Current
report

2020
QTR 4

QTR 1

2021
QTR 2

QTR 3

QTR 4

Pilot study
1 wave2 wave3 wave4 wave15

Contacts
Isabella Cecchini
Principal, PMR

Francesca Rampi
Principal, Real World Dataisabella.cecchini@iqvia.com+39 334 60 80 897

francesca.rampi@iqvia.com+39 348 0029874

Elena De SantoEngagement Manager, Oncology

Marco Zamboni
Sr Consultant, Real World Dataelena.desanto@iqvia.com+39 348 881 9160

marco,zamboni@iqvia.com+39 349 4030392© 2021. All rights reserved. IQVIA® is a registered trademark of IQVIA Inc. in the United States, theEuropean Union, and various other countries.