Governing the complexity of change: managing the drug Evrysdi(R) in the metropolitan City of Turin

The document discusses the introduction and management of the drug Evrysdi(R) in the Metropolitan City of Turin, focusing on its governance, decision-making, and operational processes. The drug is used to treat Spinal Muscular Atrophy (SMA), a rare neuromuscular disease. The initiative involved collaboration between key healthcare institutions, including the AOU Città della Salute e della Scienza di Torino and the ASL Città di Torino, to streamline the distribution and administration of this novel treatment. The case highlights the complexity of managing innovative drugs, the importance of multi-professional collaboration, and the operational challenges, such as centralizing procurement and ensuring proper patient access through hospital pharmacies. Additionally, the document covers the pivotal decisions made by clinicians, pharmacists, and regional authorities to ensure smooth implementation and continued treatment for SMA patients. Key challenges include maintaining effective communication across institutions, ensuring seamless home delivery of medications, and the development of a sustainable governance model for future healthcare innovations.