Domenico Mantoan, General Manager of AGENAS, the Italian National Agency for Regional Health Services, discusses the role of the agency in Italy's decentralised healthcare system, the National Recovery and Resilience Plan's aim to improve territorial inequalities, and the National Outcomes Program managed by AGENAS on behalf of the Ministry of Health.


Having joined AGENAS in 2020 after ten years as Regional Secretary of Health, you are an expert in the regional dimension of the Italian healthcare system. How has  your previous role prepared you for your current position?

All my previous professional experiences have contributed to my training and to creating the conditions necessary to carry out my current role within AGENAS. Moreover, in the past I already had the opportunity to collaborate with the agency, as I was a board member of AGENAS.


What is AGENAS’ role in the Italian healthcare system?

As described by Italian law, AGENAS is a technical and scientific body that carries out research activities and supports the Ministry of Health, the regions and the autonomous provinces of Trento and Bolzano. Specifically, AGENAS does research on many topics: primary care, health technology assessment, the national outcomes program, managing chronic patients through digital health, empowerment and humanisation of the healthcare system, quality and safety, etc. Furthermore, AGENAS is engaged in international research, for example, in the implementation of digitally enabled integrated person-centred care and empowering European health policies on task shifting. In addition, the agency ensures technical and operational collaboration with the regions and healthcare organisations, with respect to organisational, managerial and many other functions.


Can you share some examples of how AGENAS acts as a link between the central and regional levels of the healthcare system?

I could give you many examples, but I would like to focus on the role of AGENAS with respect to the European Union’s economic COVID-19 recovery plan, EU Next Generation, which in Italy gave birth to the National Recovery and Resilience Plan. The aim of that plan is to bridge the gap between territorial inequalities and offer greater integration between regional health services through innovative solutions.

The first part of the plan is dedicated to Italian health and is focused on strengthening primary care. In it AGENAS is described as the point of connection between the Ministry of Health and the regions for building infrastructures throughout the country. EUR 15.63 billion have been assigned to health (M6). Specifically, EUR 7 billion have been assigned to the creation and implementation of proximity networks, local structures, telemedicine for  territorial healthcare (Component 1), and EUR 8.63 billion to the development of innovation, research and digitisation of the national health service (Component 2). It is up to AGENAS, as the intermediary of the Ministry of Health, to implement the actions relating to the mission M6C1 in Component 1.

A series of initiatives have come out of the plan, some of which are already underway, such as the invitation to tender for the creation of a national telemedicine platform.


How would you qualify Italy’s response to the pandemic and the cooperation between central and regional authorities?

The whole world was faced with an unprecedented health emergency. In our country, over the last two years the government, the Ministry of Health, and the regions have been committed 24 hours a day to responding as effectively as possible to the health problems of our citizens.

It has not been easy; there have been some critical challenges, but I would like to point out that Italy is among the countries in the world with the highest number of people vaccinated.


Has AGENAS taken any steps to prepare for future pandemics?

In the latest budget law, the Italian Parliament allocated important resources to pandemic plans in all regions with the aim of being better prepared for future emergencies. AGENAS will do its part to support the Ministry of Health and the regions for the implementation of these plans.


Can you tell us about the National Outcomes Program managed by AGENAS on behalf of the Ministry of Health?

AGENAS for many years has been carrying out the important job of monitoring health interventions for healthcare decision makers and professionals by way of the National Outcomes Program. This year the program has added value because the results of the 2021 edition offer insights into the health emergency and the dynamics that COVID-19 determined with respect to the organisation of services. It is important to be aware of what has happened in order to enhance the services offered to patients.


What role does the agency play with respect to Health Technology Assessments (HTAs)?

The Italian government has outlined two measures, currently under consideration by Parliament, for the approval of national legislation to adopt the EU regulations on medical devices. These contain important innovations with respect to the evaluation of health technologies. AGENAS is expected to play a leading role in avoiding the duplication of these activities and in assuring their effectiveness.


To conclude, do you have any closing comments you would like to share with PharmaBoardroom’s audience ?

About a month ago the Italian Parliament adopted important measures regarding the governance of digital health, entrusting AGENAS with the role of “agency for digital health”. The objective is to ensure the digitalisation of services and processes in healthcare equally throughout the national territory.

I believe that the effective management of health data can lead to important developments not only on a national level, especially considering what has happened in the world of research in the last two years. A digital health agency, therefore, is certainly an important decision, focusing on the health of Italian citizens and beyond.