Estudo de custo-análise do tratamento da artrite reumatoide grave em um município do Sul do Brasil

Buendgens, Fabíola Bagatini; Blatt, Carine Raquel; Marasciulo, Antônio Carlos Estima; Leite, Silvana Nair; Farías, Mareni Rocha

doi:10.1590/0102-311x00013513

Cited by 10 publications

(9 citation statements)

References 25 publications

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“…The HCV per capita annual costs in the present cohort was USD 6,152.85 (BRL 4,819.93). These costs were higher than direct costs of other chronic condition in Brazilian populations, such as diabetes (USD 1,012) (44) , and non-melanoma skin cancer (BRL 1,172) (45) ; but lower than rheumatoid arthritis (BRL 19,860.16) (46) . In addition, the results showed that drug treatment was the costliest component, accounting for 95.9% of total HCV costs; accordingly, a Brazilian study conducted prior to the incorporation of protease inhibitors have shown that drug treatment represented 88.2% of the total costs (47) .…”

Section: Discussionmentioning

confidence: 98%

Hepatitis C in the Brazilian Public Health Care System: Burden of Disease

Castelo

Mello

Teixeira

et al. 2018

Arq. Gastroenterol.

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BACKGROUND: Infection by hepatitis C virus is one of the leading causes of chronic hepatitis C and cause severe burden for patients, families and the health care system. OBJECTIVE: The aims of this research were to assess the severity of liver fibrosis, comorbidities and complications of hepatitis C virus; to examine health-related quality of life (HRQoL), productivity loss and resource use and costs in a sample of Brazilian chronic hepatitis C, genotype 1, patients. METHODS: This was a cross-sectional multicenter study performed in genotype-1 chronic hepatitis C patients to assess disease burden in the Brazilian public health care system between November 2014 and March 2015. Patients were submitted to a liver transient elastography (FibroScan) to assess liver fibrosis and answered an interview composed by a questionnaire specifically developed for the study and three standardized questionnaires: EQ-5D-3L, HCV-PRO and WPAI:HepC. RESULTS: There were 313 subjects enrolled, with predominance of women (50.8%), caucasian/white (55.9%) and employed individuals (39.9%). Mean age was 56 (SD=10.4) years old. Moreover, 42.8% of patients who underwent FibroScan were cirrhotic; the most frequent comorbidity was cardiovascular disease (62.6%) and the most frequent complication was esophageal varices (54.5%). The results also showed that “pain and discomfort” was the most affected HRQoL dimension (55.0% of patients reported some problems) and that the mean HCV-PRO overall score was 69.1 (SD=24.2). Regarding productivity loss, the most affected WPAI:HepC component was daily activity (23.5%) and among employed patients, presenteeism was more frequent than absenteeism (18.5% vs 6.5%). The direct medical costs in this chronic hepatitis C sample was 12,305.72USD per patient in the 2 years study period; drug treatment costs represented 95.9% of this total. CONCLUSION: This study showed that most patients are cirrhotic, present high prevalence of cardiometabolic diseases and esophageal varices, reduced HRQoL mainly in terms of pain/discomfort, and work productivity impairment, especially presenteeism. Additionally, we demonstrated that hepatitis C virus imposes an economic burden on Brazilian Health Care System and that most of this cost is due to drug treatment.

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Section: Discussionmentioning

confidence: 98%

Hepatitis C in the Brazilian Public Health Care System: Burden of Disease

Castelo

Mello

Teixeira

et al. 2018

Arq. Gastroenterol.

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“…Previous cost analysis related to RA treatment in Brazil estimates the economic impact of the disease reaching almost 20,000 BRL, considering all costs categories, and the expenses related to drug therapies are the main cost driver (Buendgens et al, 2013;Chermont et al, 2008;de Azevedo et al, 2008). In this scenario, this study provides important information to help the decision-making process.…”

Section: Drugmentioning

confidence: 93%

“…Disease treatment is determined in accordance with the stage at diagnosis and aims to improve patients' quality of life, control the progression of joint lesions, prevent functional loss and decrease pain (Smolen et al, 2016). Therapy may involve the use of medications, non-pharmacologic therapies, consultations with specialists, complementary exams and several other procedures (Buendgens et al, 2013). Thus, an economic burden is also observed.…”

Section: Introductionmentioning

confidence: 99%

“…In Brazil, the estimated economic impact of the disease ranges from 19,860.16 Brazilian Real (BRL) to 5,889.13 BRL [2,423.51 American dollars (USD); using 2005 Brazilian currency; 1 USD = 2.43 BRL], considering all cost categories (Buendgens et al, 2013;Chermont et al, 2008;de Azevedo et al, 2008). Costs related to drug therapy represents 90.8% of total direct medical costs and 58.78% of all direct costs (Buendgens et al, 2013;Chermont et al, 2008). The public assistance is responsible for financing 73.6% of direct medical cost and 79.3% of drugs (Buendgens et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

“…Costs related to drug therapy represents 90.8% of total direct medical costs and 58.78% of all direct costs (Buendgens et al, 2013;Chermont et al, 2008). The public assistance is responsible for financing 73.6% of direct medical cost and 79.3% of drugs (Buendgens et al, 2013). According to the Organization for Economic Cooperation and Development (OECD), costs related to RA treatment are greater than health expenses per capita in several countries, including Brazil, when gross domestic product and health expenditures are analyzed.…”

Section: Introductionmentioning

confidence: 99%

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Cost-minimization analysis of biological disease-modifying antirheumatic drugs in the Brazilian public health system (SUS) considering patients’ weight

Yazawa¹

2019

JBES

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Objective: To perform a cost-minimization analysis comparing the cohort with the current average patient weight of 70 kg (MoH current assumption). Since most rheumatoid arthritis (RA) patients in Brazil are women (60 kg or less), we also aimed to define this percentage at Brazilian public healthcare system (SUS). Methods: Treatment-naïve RA patients using biologics from January 2008 to November 2018 were retrieved from Datasus as well as the number of patients ≤ 60 kg and their drug use distribution. Data on drug costs were assessed from the last payment reported by MoH and then recalculated using the weighted average of 60 kg and a 52-weeks a year to assess cost-minimization. Results: In the studied cohort, 33,646 patients (33.3%) were classified as ≤ 60 kg. Annual cost per patient, considering an average weight of 60 kg, ranged from 2,872,29 USD to 4,223.93 USD. Tocilizumab 80 mg was the only drug demonstrating a reduction in annual cost per patient (-526.79 USD). Conclusion: Cost-minimization analysis based on weight-dependent dosage showed that tocilizumab could reduce MoH costs with RA treatment in 14.28%. By adopting weight-dependent dose of 60 kg, the Brazilian government could save up to 916,651.31 USD per year using tocilizumab versus other biological disease-modifying antirheumatic drugs (DMARDs). In ten years, it represents an accumulative saving of 9,166,513.57 USD.

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Burden of illness of rheumatoid arthritis in Latin America: a regional perspective

2015

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Rheumatoid arthritis (RA) is one of the most important rheumatic diseases. Its prevalence varies among ethnic groups. Genetic and environmental factors influence its incidence and prevalence. This chronic disease will increase its frequency in the future due to population aging. The personal impact of this disease on many relevant areas of an individual requires special efforts to prevent and treat it properly. Adequate advice on several recently described risk factors such as tobacco and alcohol exposure, infections, obesity, and physical exercise should be part of every medical consultation. This knowledge should be incorporated to improve health care prevention programs. Patients and clinicians must work together through better communication skills to finally improve outcomes. Including RA in priority health care lists will need special effort from rheumatology societies and better communication with policy makers.

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Estudo de custo-análise do tratamento da artrite reumatoide grave em um município do Sul do Brasil

Cited by 10 publications

References 25 publications

Hepatitis C in the Brazilian Public Health Care System: Burden of Disease

Hepatitis C in the Brazilian Public Health Care System: Burden of Disease

Cost-minimization analysis of biological disease-modifying antirheumatic drugs in the Brazilian public health system (SUS) considering patients’ weight

Burden of illness of rheumatoid arthritis in Latin America: a regional perspective

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