Gastos publicos com medicamentos para o tratamento da osteoporose na pos-menopausa

Abstract

OBJECTIVE:To analyze expenditure on treatment for postmenopausal osteoporosis and associated factors on mean per capita expenditure. METHODS:A probabilistic-deterministic linkage between the database of Authorizations for Highly Complex Procedures and the mortality information system was constructed, resulting in a historical cohort of patients using highcost medications for the treatment of postmenopausal osteoporosis, between 2000 and 2006.Mean monthly spending on medicines was stratifi ed by age group and described according to demographic and clinical characteristics and the type of drug used.A linear regression model was used to assess the impact of demographic and clinical characteristics on per capita mean monthly expenditure on medicines. RESULTS:We identifi ed 72,265 women who received drugs for the treatment of postmenopausal osteoporosis.The average monthly expenditure per capita in the fi rst year of treatment was $ 54.02 (sd $ 86.72).The population was predominantly composed of women aged 60-69 years old, who had started treatment in 2000, resident in the Southeast of Brazil, who had previously suffered osteoporotic fractures, and Alendronate sodium was the drug most commonly used at baseline.For most of the patients, the same active ingredient remained in use throughout the treatment period.During the program, 6,429 deaths were identifi ed among participants.More than a third of women remained in treatment for up to 12 months.Raloxifen and calcitonin were the therapeutic alternatives with the greatest impact on the average monthly expenditure on medicine using alendronate sodium as a reference standard. CONCLUSIONS:Due to the high impact of the type of drug used on expenditure on medication, it is recommended that criteria for prescribing and dispensing be established by prioritizing those with lower costs and greater effectiveness in order to optimize the process of pharmaceutical care and provide the population with a greater number of pharmaceutical units.

Osteoporose e Expectativa de Vida Saudável: estimativas para o Brasil em 2008

“…Apesar disso, a osteoporose deve ser considerada como um sério problema de saude pública, principalmente pelo seu potencial em acarretar incapacidades, influenciando negativamente o cotidiano das pessoas, seu bem-estar e qualidade de vida 39,43 . Além disso, essa patologia se configura como um problema de elevado custo para o sistema de saúde, devido ao seu tratamento propriamente dito e pelos custos decorrentes das quedas associadas à doença 44 . As estimativas realizadas no presente artigo podem auxiliar no desenvolvimento de políticas públicas voltadas para o tratamento e suporte adequado para pessoas com osteoporose, prevenindo fraturas e suas consequências.…”

The epidemiology and management of postmenopausal osteoporosis: a viewpoint from Brazil

“…58 Drug treatment for osteoporosis can decrease the morbidity and mortality of the disease and can decrease costs resulting from fractures caused by low-impact trauma. Brandão et al 59 analyzed data from a historical cohort of 72,265 women using medications provided by the SUS for postmenopausal osteoporosis between the years 2000 and 2006. The average monthly per capita expenditure in the first year of treatment was approximately USD54.00, and most women used the same medication throughout the treatment period (89.8%).…”

“…With regard to costs, raloxifene and calcitonin were associated with the greatest expenses for the SUS. 59 …”