The Relevance of Shared Decision-Making and Actor Engagement for the Economic Sustainability of Healthcare Service: Insights from the Experience of an Italian Local Authority

This work aims to contribute to investigating the governance conditions of the economic sustainability of the Italian healthcare system when reconciling the effectiveness and sustainability of service is complex due to the diverging goals and interests of the involved actors. Benefitting from the adoption of a service and systems perspective, the specific purpose of this paper is to highlight the relevance of sharing information and actor engagement in complex decision contexts. The focus is on local authorities’ expenditure containment strategies based on the use of biosimilar drugs.