Avaliação econômica do tratamento da esquizofrenia com antipsicóticos no Sistema Único de Saúde

Lindner, Leandro; Marasciulo, Antônio Carlos Estima; Farías, Mareni Rocha; Grohs, Geder Evandro Motta

doi:10.1590/s0034-89102009000800010

Cited by 28 publications

(17 citation statements)

References 9 publications

(17 reference statements)

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“…Atypical antipsychotic monotherapy costs can be 167 times greater than typical antipsychotic monotherapy costs [ 38 ]. A Brazilian cost-utility study reported that the economic impact of olanzapine on public health services was greater than risperidone and haloperidol [ 39 ]. In our study, almost half of direct health care costs (excluding the residential facilities) were due to antipsychotic costs, with olanzapine costs corresponding to more than half of all psychotropic costs.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Antipsychotic Polytherapy Costs in the Public Health Care in Sao Paulo, Brazil

et al. 2015

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IntroductionGuidelines for the treatment of psychoses recommend antipsychotic monotherapy. However, the rate of antipsychotic polytherapy has increased over the last decade, reaching up to 60% in some settings. Studies evaluating the costs and impact of antipsychotic polytherapy in the health system are scarce.ObjectiveTo estimate the costs of antipsychotic polytherapy and its impact on public health costs in a sample of subjects with psychotic disorders living in residential facilities in the city of Sao Paulo, Brazil.MethodA cross-sectional study that used a bottom-up approach for collecting costs data in a public health provider´s perspective. Subjects with psychosis living in 20 fully-staffed residential facilities in the city of Sao Paulo were assessed for clinical and psychosocial profile, severity of symptoms, quality of life, use of health services and pharmacological treatment. The impact of polytherapy on total direct costs was evaluated.Results147 subjects were included, 134 used antipsychotics regularly and 38% were in use of antipsychotic polytherapy. There were no significant differences in clinical and psychosocial characteristics between polytherapy and monotherapy groups. Four variables explained 30% of direct costs: the number of antipsychotics, location of the residential facility, time living in the facility and use of olanzapine. The costs of antipsychotics corresponded to 94.4% of the total psychotropic costs and to 49.5% of all health services use when excluding accommodation costs. Olanzapine costs corresponded to 51% of all psychotropic costs.ConclusionAntipsychotic polytherapy is a huge economic burden to public health service, despite the lack of evidence supporting this practice. Great variations on antipsychotic costs explicit the need of establishing protocols for rational antipsychotic prescriptions and consequently optimising resource allocation. Cost-effectiveness studies are necessary to estimate the best value for money among antipsychotics, especially in low and middle income countries.

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Section: Discussionmentioning

confidence: 99%

The Impact of Antipsychotic Polytherapy Costs in the Public Health Care in Sao Paulo, Brazil

et al. 2015

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“…The pharmacological treatment of this disorder involves drugs of various pharmacological classes, among them the most used are antipsychotics 30 . This disease is constantly related to the dopaminergic hypothesis that proposes schizophrenia as a disturbing disorder associated with dopaminergic dysfunction, but with a series of indicative evidence that other neuroreceptor systems are involved in the pathophysiology of the disorder, including glutaminergic receptors 31 .…”

Section: Schizophreniamentioning

confidence: 99%

The New Approaches Therapeutics That Complement Medicinal Therapy of Patients in Mental Health: an Analysis

Silva¹,

Assunção²,

Silva³

et al. 2020

AJPRR

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Mental illnesses represent a challenge for healthcare worldwide. In Brazil, this reality is not different, with the Unified Health System (SUS) providing or improving the therapeutic treatment of patients assisted by public health policies, through the implementation of integrative and complementary practices in mental health patient therapy. Drug therapy associated with the increase in integrative practices contributes to improvements in the patient, in addition to promoting updates to the protocols and clinical guidelines that address pathologies of the mental nature. In this context, this chapter should analyze the main mental disorders, such as drug therapies used to treat these patients, as well as the use of integrative practices that complement the use of medications.

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“…From August 2012 to July 2013, the SUS spent an estimated $US181 million [converted using the purchasing power parity (PPP) conversion factor of the World Bank of 2012, $US1 = 1.559 Brazilian Real (BRL)] [ 16 ] on atypical antipsychotics alone, representing 7.3% of the total amount spent on high-cost drugs in Brazil during that period [ 12 ]. Other Brazilian studies have evaluated the costs associated with the use of antipsychotics, albeit with considerable methodological heterogeneity and with different objectives [ 17 – 19 ].…”

Section: Introductionmentioning

confidence: 99%

Costs in the Treatment of Schizophrenia in Adults Receiving Atypical Antipsychotics: An 11-Year Cohort in Brazil

Barbosa

Costa

Lemos

et al. 2018

Appl Health Econ Health Policy

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BackgroundSchizophrenia is associated with significant economic burden. In Brazil, antipsychotic drugs and outpatient and hospital services are provided by the Brazilian National Health System (SUS) for patients with schizophrenia. However, few studies capture the cost of managing these patients within the Brazilian NHS. This is important to appraise different management approaches within universal healthcare systems.ObjectiveOur objective was to use real-world data to describe the costs associated with the treatment of schizophrenia in adults receiving atypical antipsychotics in Brazil from 2000 to 2010.MethodsWe integrated three national databases for adult patients with schizophrenia receiving one or more atypical antipsychotics. We assessed only direct medical costs and the study was conducted from a public-payer perspective. A multivariate log-linear regression model was performed to evaluate associations between costs and clinical and demographic variables.ResultsWe identified 174,310 patients with schizophrenia, with mean ± standard deviation (SD) annual costs of $US1811.92 ± 284.39 per patient. Atypical antipsychotics accounted for 79.7% of total costs, with a mean annual cost per patient of $US1578.74 ± 240.40. Mean annual costs per patient were $US2482.90 ± 302.92 for psychiatric hospitalization and $US862.96 ± 160.18 for outpatient psychiatric care. Olanzapine was used by 47.7% of patients and represented 62.8% of the total costs of atypical antipsychotics. Patients who used clozapine had the highest mean annual cost per patient for outpatient psychiatric care and psychiatric hospitalization.ConclusionsAtypical antipsychotics were responsible for the majority of the schizophrenia treatment costs, and psychiatric hospitalization costs were the highest mean annual cost per patient. Authorities should ensure efficient use of atypical antipsychotics and encourage outpatient psychiatric care over psychiatric hospitalization where possible.Electronic supplementary materialThe online version of this article (10.1007/s40258-018-0408-4) contains supplementary material, which is available to authorized users.

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Avaliação econômica do tratamento da esquizofrenia com antipsicóticos no Sistema Único de Saúde

Cited by 28 publications

References 9 publications

The Impact of Antipsychotic Polytherapy Costs in the Public Health Care in Sao Paulo, Brazil

The Impact of Antipsychotic Polytherapy Costs in the Public Health Care in Sao Paulo, Brazil

The New Approaches Therapeutics That Complement Medicinal Therapy of Patients in Mental Health: an Analysis

Costs in the Treatment of Schizophrenia in Adults Receiving Atypical Antipsychotics: An 11-Year Cohort in Brazil

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