Management and utilization of the Fund for Innovative Medicines: a multistakeholder qualitative survey on regional and local practices

Introduction: The Fund for Innovative Medicines, Fondo Farmaci Innovativi (FFI), enables financing, non-competition, and fast access to innovative medicines. However, limited evidence exists regarding its management processes and the stakeholders involved. In order to identify characteristics, critical issues, and improvement opportunities, this analysis investigates the FFI management processes through the perspective of the Key Opinion Leaders (KOLs) involved. Methods: The research employs a qualitative research methodology. A survey administered through interviews to 18 KOLs (clinicians, hospital pharmacists, top hospital managers, and regional pharmaceutical service directors) from 9 Italian regions provided evidence of FFI utilization patterns. The content analysis identified FFI management features, challenges, and best practices. The expert meeting discussion validated the findings and developed consensus priority recommendations. Results: The FFI regulation promotes the convergence between regional and local authorities; however, different regional governance models may determine varying levels of organizational efficiency. Critical interventions were proposed: overall, enhanced AIFA data feedback is supported by 85% of the sample; regionally, strengthened communication with local institutions and centralized planning are recommended (mean score 3.2/4); locally, enhanced digitalization of reporting systems may address operational inefficiencies for clinicians and hospital pharmacists (mean score 3.4/4). Conclusion: This analysis contributed to a better awareness of the current FFI management process through a multi-level and multi-professional methodology. Partial return of data, potential distortions of a fund’s allocation based on usage, multiplication of accounting processes, and regional variability in healthcare governance provide a foundation for targeted improvement interventions and to direct future research.